수근관 증후군에서 Agee 술식을 이용한 내시경적 감압술

Abstract

Purpose: The purpose of this article is to analyze the results of Agee endoscopic carpal tunnel release in the management of carpal tunnel syndrome. Materials and Methods: The forty-six patients (68 hands) who were treated at our hospital from Aug. 1996 to Apr. 1999 were followed up for more than 1 year. Retrospective analyses were made between the sex, age, history, clinical symptoms and subjective satisfaction. Results : Number of patients included in our study were 6 males and 40 females. Of these, 22 patients were diagnosed with carpal tunnel syndrome in both hands, thus making the total of 68 cases. The average age at the time of operation was 54.4 years(28∼79). The etiology of carpal tunnel syndrome were as follows: idiopathic in 46 hands; predisposing trauma or disease in 22 hands. Paresthesia(53%), thenar muscle atrophy (54%), tinel sign(52%), positive Phalen test (51%) were demonstrated in our patients preoperatively. Post-operative complications included 5 cases of 3rd and 4th finger tip paresthesia, 2 cases of weakened grasp power and a recurrent symptom after operation. Pilar pain and scar pain which were also noted all disappeared at the final follow up. Patients satisfaction on visual analogue scale improved to 9.1 points from a pre- operative 6.3 points. Conclusion: Complications such as partial paresthesia or weakend grasp power arose in 12% although no serious complications arose. The Agee endoscopic carpal tunnel release is a relatively safe and effective method in treating carpal tunnel syndrome. In cases where alteration of the wrist joint area anatomy are expected, pre-operative definitive diagnostic imagings or operative transformations of the altered anatomy are believed to be mandatory