Muhammed Çağatay Engin, Mehmet Demirel, Abdullah Kahraman, Ömer Ayık
{"title":"桡骨隧道综合征的骨科治疗:诊断和治疗的困境。","authors":"Muhammed Çağatay Engin, Mehmet Demirel, Abdullah Kahraman, Ömer Ayık","doi":"10.5152/eurasianjmed.2023.22274","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The first-line treatment for radial tunnel syndrome is conservative despite limited evidence concerning its efficiency. Surgical release is indicated if nonsurgical measures fail. Radial tunnel syndrome cases may be misdiagnosed as the more common lateral epicondylitis, and misdiagnosing radial tunnel syndrome causes wrong treatment and, thus, the perpetuation or increase of the pain. Although radial tunnel syndrome is a rare disorder, such cases can be encountered in tertiary hand surgery centers. This study aimed to present our experience in diagnosing and managing patients with radial tunnel syndrome.</p><p><strong>Material and methods: </strong>Eighteen patients (7 male, 11 female; mean age=41.5 years, age range=22-61) in whom radial tunnel syndrome was diagnosed and treated at a single tertiary care center were retrospectively reviewed and included. Previous diagnoses (wrong diagnosis, delayed diagnosis, missed diagnosis, and other), previous treatments for such diagnoses, and their results before presenting to our institution were recorded. The shortened disabilities of the arm, shoulder, and hand questionnaire score and visual analog scale score were recorded before the surgery and at the final follow-up appointment.</p><p><strong>Results: </strong>All the patients included in the study underwent steroid injections. Eleven patients (11/18, 61%) benefited from steroid injection and conservative treatment. The remaining 7 patients refractory to conservative treatment were offered surgical treatment. Of these, 6 patients accepted surgery while 1 did not accept it. In all patients, the mean visual analog scale score significantly improved from 6.38 (range: 5-8) to 2.1 (range: 0-7) (P < .001). The mean quick-disabilities of the arm, shoulder, and hand questionnaire scores were significantly improved from 43.4 (range: 31.8-52.5) preoperatively to 8.7 (range: 0-45.5) at the final follow-up (P < .001). In the surgical treatment group, the mean visual analog scale score significantly improved from 6.1 (range: 5-7) to 1.2 (range: 0-4) (P < .001). The mean quick-disabilities of the arm, shoulder, and hand questionnaire scores were significantly improved from 37.4 (range: 31.2-45.5) preoperatively to 4.7 (range: 0-13.6) at the final follow-up (P < .001).</p><p><strong>Conclusion: </strong>Our experience has shown that satisfactory results can be obtained by surgical treatment for patients with radial tunnel syndrome refractory to nonsurgical treatment whose diagnosis is confirmed by a thorough physical examination.</p>","PeriodicalId":53592,"journal":{"name":"Eurasian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.9000,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10081130/pdf/","citationCount":"1","resultStr":"{\"title\":\"Orthopedic Management of Radial Tunnel Syndrome: A Diagnostic and Treatment Dilemma.\",\"authors\":\"Muhammed Çağatay Engin, Mehmet Demirel, Abdullah Kahraman, Ömer Ayık\",\"doi\":\"10.5152/eurasianjmed.2023.22274\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The first-line treatment for radial tunnel syndrome is conservative despite limited evidence concerning its efficiency. Surgical release is indicated if nonsurgical measures fail. Radial tunnel syndrome cases may be misdiagnosed as the more common lateral epicondylitis, and misdiagnosing radial tunnel syndrome causes wrong treatment and, thus, the perpetuation or increase of the pain. Although radial tunnel syndrome is a rare disorder, such cases can be encountered in tertiary hand surgery centers. This study aimed to present our experience in diagnosing and managing patients with radial tunnel syndrome.</p><p><strong>Material and methods: </strong>Eighteen patients (7 male, 11 female; mean age=41.5 years, age range=22-61) in whom radial tunnel syndrome was diagnosed and treated at a single tertiary care center were retrospectively reviewed and included. Previous diagnoses (wrong diagnosis, delayed diagnosis, missed diagnosis, and other), previous treatments for such diagnoses, and their results before presenting to our institution were recorded. The shortened disabilities of the arm, shoulder, and hand questionnaire score and visual analog scale score were recorded before the surgery and at the final follow-up appointment.</p><p><strong>Results: </strong>All the patients included in the study underwent steroid injections. Eleven patients (11/18, 61%) benefited from steroid injection and conservative treatment. The remaining 7 patients refractory to conservative treatment were offered surgical treatment. Of these, 6 patients accepted surgery while 1 did not accept it. In all patients, the mean visual analog scale score significantly improved from 6.38 (range: 5-8) to 2.1 (range: 0-7) (P < .001). The mean quick-disabilities of the arm, shoulder, and hand questionnaire scores were significantly improved from 43.4 (range: 31.8-52.5) preoperatively to 8.7 (range: 0-45.5) at the final follow-up (P < .001). In the surgical treatment group, the mean visual analog scale score significantly improved from 6.1 (range: 5-7) to 1.2 (range: 0-4) (P < .001). 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Orthopedic Management of Radial Tunnel Syndrome: A Diagnostic and Treatment Dilemma.
Objective: The first-line treatment for radial tunnel syndrome is conservative despite limited evidence concerning its efficiency. Surgical release is indicated if nonsurgical measures fail. Radial tunnel syndrome cases may be misdiagnosed as the more common lateral epicondylitis, and misdiagnosing radial tunnel syndrome causes wrong treatment and, thus, the perpetuation or increase of the pain. Although radial tunnel syndrome is a rare disorder, such cases can be encountered in tertiary hand surgery centers. This study aimed to present our experience in diagnosing and managing patients with radial tunnel syndrome.
Material and methods: Eighteen patients (7 male, 11 female; mean age=41.5 years, age range=22-61) in whom radial tunnel syndrome was diagnosed and treated at a single tertiary care center were retrospectively reviewed and included. Previous diagnoses (wrong diagnosis, delayed diagnosis, missed diagnosis, and other), previous treatments for such diagnoses, and their results before presenting to our institution were recorded. The shortened disabilities of the arm, shoulder, and hand questionnaire score and visual analog scale score were recorded before the surgery and at the final follow-up appointment.
Results: All the patients included in the study underwent steroid injections. Eleven patients (11/18, 61%) benefited from steroid injection and conservative treatment. The remaining 7 patients refractory to conservative treatment were offered surgical treatment. Of these, 6 patients accepted surgery while 1 did not accept it. In all patients, the mean visual analog scale score significantly improved from 6.38 (range: 5-8) to 2.1 (range: 0-7) (P < .001). The mean quick-disabilities of the arm, shoulder, and hand questionnaire scores were significantly improved from 43.4 (range: 31.8-52.5) preoperatively to 8.7 (range: 0-45.5) at the final follow-up (P < .001). In the surgical treatment group, the mean visual analog scale score significantly improved from 6.1 (range: 5-7) to 1.2 (range: 0-4) (P < .001). The mean quick-disabilities of the arm, shoulder, and hand questionnaire scores were significantly improved from 37.4 (range: 31.2-45.5) preoperatively to 4.7 (range: 0-13.6) at the final follow-up (P < .001).
Conclusion: Our experience has shown that satisfactory results can be obtained by surgical treatment for patients with radial tunnel syndrome refractory to nonsurgical treatment whose diagnosis is confirmed by a thorough physical examination.
期刊介绍:
Eurasian Journal of Medicine (Eurasian J Med) is an international, scientific, open access periodical published by independent, unbiased, and triple-blinded peer-review principles. The journal is the official publication of Atatürk University School of Medicine and published triannually in February, June, and October. The publication language of the journal is English. The aim of the Eurasian Journal of Medicine is to publish original research papers of the highest scientific and clinical value in all medical fields. The Eurasian J Med also includes reviews, editorial short notes and letters to the editor that either as a comment related to recently published articles in our journal or as a case report. The target audience of the journal includes researchers, physicians and healthcare professionals who are interested or working in in all medical disciplines.