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Endoskopische karpaltunnelspaltung

Endoscopic carpal tunnel release

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Zusammenfassung

Grundlagen

Obwohl die endoskopische Karpaltunnelspaltung seit mehr als 5 Jahren angewandt wird, bestehen nach wie vor kontroversielle Ansichten bezüglich der Effektivität und Sicherheit dieser Technik.

Methodik

An Hand eigener Erfahrungen mit 157 endoskopischen Karpaltunnelspaltungen und nach Durchsicht der Literatur wird der aktuelle Stellenwert der endoskopischen Karpaltunnelspaltung im Vergleich zur konventionellen offenen Methode erörtet.

Ergebnisse

Die Vorteile der endoskopischen Karpaltunnelspaltung gegenüber der konventionellen Methode bestehen primär in der frühen postoperativen Phase und äußern sich in geringeren Wund-und Narbenschmerzen sowie einer rascheren Wiedererlangung der Funktionalität. Allerdings erfordert diese Technik ausreichende Übung und handchirurgische Erfahrung, da das Risiko einer iatrogenen Verletzung der Gefäß-und Nervenstrukturen besonders in der Karpaltunnelspaltung.

Schlußfolgerungen

Die endoskopische Karpaltunnelspaltung stellt bei entsprechender Indikationsstellung eine wertvolle Ergänzung zur konventionellen offenen Methode dar. Der Patient muß über das mögliche Komplikationsrisiko aufgeklärt und soll in die Wahl der Operationsmethode mit einbezogen werden.

Summary

Background

Although the endoscopic carpal tunnel release has been in use since 1989 there is still considerable disagreement regarding the safety and efficacy of this procedure.

Methods

By means of our own experience with 157 endoscopic carpal tunnel procedures and guided by the literature the value of the endoscopic carpal tunnel procedure compared to the conventional open method will be discussed in detail.

Results

The advantages of the endoscopic carpal tunnel release over the standard open technique are evident in the early post-operative period and become apparent in less scar tenderness and an earlier functional recovery. However, the endoscopic carpal tunnel release is a technical demanding procedure and the risk of inadvertent damage to the neurovascular structures always remains a possibility.

Conclusions

Although the endoscopic carpal tunnel procedure has advantages over the standard open release this technique is not suitable for every patient and every surgeon. Early conversion to an open technique is recommendable whenever the transverse fibers of the flexor retinaculum are not clearly seen.

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Authors and Affiliations

  1. Abteilung für Plastische Chirurgie der Universitätsklinik für Chirurgie, Graz

    H. Hoflehner & G. Pierer

  2. I. Anatomischen Institut der Universität Wien, Wien, Österreich

    M. tschabitscher

  3. Klinik für Radiodiagnostik der Universitätsklinik Wien, Wien, Österreich

    M. Metz

  4. Abteilung für Plastische und Wiederherstellungschirurgie, Wilhelminenspital, Montleart-straße 37, A-1171, Wien, Österreich

    A. P. Worseg, R. Kuzbari, I. Schlenz, H. Koncilia & J. Holle

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  1. A. P. Worseg
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Worseg, A.P., Hoflehner, H., Kuzbari, R. et al. Endoskopische karpaltunnelspaltung. Acta Chir Austriaca 27, 277–282 (1995). https://doi.org/10.1007/BF02625979

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