Endoscopic carpal tunnel release in Jamaica--seven years experience.

OBJECTIVE: To assess the patient profile and outcome of treatment, by endoscopic release, of patients with carpal tunnel syndrome. METHODS: A descriptive study was done using data from two sets of patients who had endoscopic carpal tunnel release in Jamaica from 2004 to 2006 and 2006 to 2010. The medical records of patients who had a diagnosis of carpal tunnel syndrome using symptoms, clinical signs and confirmation by nerve conduction test were reviewed. The data were analysed using SPSS and Micosoft Excel. RESULTS: A total of 68 patients with 75 cases of carpal tunnel syndrome were done. Fifty-two (76%) of these patients were females and about 50% were older than 41 years old. There were 61 (90%) unilateral cases. Of these, the majority of cases affected the right hand. All patients had improvement in symptoms after one week, required minimal analgesic use, had good compliance with rehabilitation and returned to work after about two weeks. There were three cases of pilar tenderness, two cases of transient paraesthesia in the index finger which resolved after three weeks. There were three failed cases from the first series which had to be converted to open carpal tunnel release. The complication rate was 6.7%. No serious complications occurred in the second series and all were treated successfully without interventional surgery. The rate of conversion to open release was 4%. CONCLUSION: Carpal tunnel affects mostly middle aged females and when treatment is done by endoscopic release, there is a fast resolution of symptoms and early return to work.

Endoscopic carpal tunnel release in jamaica: seven years experience / Liberación endoscópica del túnel carpiano en jamaica: siete anos de experiencia

OBJECTIVE: To assess the patient profile and outcome of treatment, by endoscopic release, of patients with carpal tunnel syndrome. METHODS: A descriptive study was done using data from two sets ofpatients who had endoscopic carpal tunnel release in Jamaica from 2004 to 2006 and 2006 to 2010. The medical records of patients who had a diagnosis of carpal tunnel syndrome using symptoms, clinical signs and confirmation by nerve conduction test were reviewed. The data were analysed using SPSS and Micosoft Excel®. RESULTS: A total of 68 patients with 75 cases of carpal tunnel syndrome were done. Fifty-two (76%) of these patients were females and about 50% were older than 41 years old. There were 61 (90%) unilateral cases. Of these, the majority of cases affected the right hand. All patients had improvement in symptoms after one week, required minimal analgesic use, had good compliance with rehabilitation and returned to work after about two weeks. There were three cases of pilar tenderness, two cases of transient paraesthesia in the index finger which resolved after three weeks. There were three failed cases from the first series which had to be converted to open carpal tunnel release. The complication rate was 6.7%. No serious complications occurred in the second series and all were treated successfully without interventional surgery. The rate ofconversion to open release was 4%. CONCLUSION: Carpal tunnel affects mostly middle aged females and when treatment is done by endoscopic release, there is a fast resolution of symptoms and early return to work.

OBJETIVO: Evaluar el perfil del paciente y el resultado clínico del tratamiento de pacientes con el síndrome del túnel carpiano tratados mediante liberación endoscópica. MÉTODOS: Se llevó a cabo un estudio descriptivo, usando datos de dos conjuntos de pacientes a quienes se les realizó una liberación endoscópica del túnel carpiano en Jamaica entre 2004 y 2006; 2006 y 2010. Se revisaron las historias clínicas de pacientes con un diagnóstico de síndrome del túnel carpiano, usando síntomas, senales clínicas y confirmación mediante la prueba de conducción de nervio. Los datos fueron analizados usando SPSS y Micosoft Excel®. RESULTADOS: Se analizó un total de 68 pacientes con 75 casos de síndrome del túnel carpiano. Cincuenta y dos (76%) de estas pacientes fueron mujeres, y aproximadamente 50% tenían más de 41 anos de edad. Hubo 61 (90%) casos unilaterales. De éstos, la mayoría de casos tuvo afectación de la mano derecha. Todos los pacientes experimentaron una mejoría en los síntomas después de una semana; necesitaron un uso mínimo de analgésicos, cumplieron bien con la rehabilitación, y regresaron al trabajo luego de dos semanas aproximadamente. Hubo tres casos de sensibilidad del talón de la mano, y dos casos deparestesia transitoria del dedo índice, que se resolvieron después de tres semanas. Hubo tres casos fallidos que tuvieron que ser convertidos en liberación abierta del túnel carpiano. La tasa de complicación fue 6.7%. No ocurrió ninguna complicación seria en esta serie, y todas fueron tratadas exitosamente sin intervención quirúrgica. La tasa de conversión para abrir la liberación fue 4%. CONCLUSIÓN: El túnel carpiano afecta principalmente a las mujeres de mediana edad, y cuando el tratamiento se realiza mediante liberación endoscópica, se produce una resolución rápida de los síntomas y un temprano regreso al trabajo.