Đặc điểm hình ảnh và vai trò siêu âm trong chẩn đoán và theo dõi sau phẩu thuật hội chứng ống cổ tay

Imaging characteristics and the role of ultrasound on diagnosis and tracking after surgical treatment carpal tunnel syndrome

SUMMARY

Carpal tunnel syndrome quite commonly, pinched median nerves can cause muscle atrophy, reduced function and motor of hand. Surgical treatment of carpal tunnel syndrome cut carpal ligament is the most thorough treatment. Ultrasound is one of the means to applied in the diagnosis and tracking after of the disease.

Objectives: 1) Describing the characteristic ultrasound images of carpal tunnel syndrome; 2) Analyzing the ultrasound images before and after surgery treatment of carpal tunnel syndrome.

Subjects and Method: A prospective study of 33 patients with 37 hands, who underwent open surgical for carpal tunnel syndrome from November 2013 to September 2014 at the hospital in Hanoi medical University. The patients were clinical examination, electromechanics and ultrasonography carpal tunnel before and after the operation.

Results: The area of median nerve segment near pronator quadratus muscle in pre-treatment period 6.4±1.3mm2, near proximal carpal tunnel 17.3±7.2mm2, in carpal tunnel 8.3±2.7mm2, outlet carpal tunnel 9.0±2.8mm2. The common signs of neuronal injury median as: swelling of the nerve median positive 94.6%, Notch sign positive 73%, Delta sign S>2mm2 positive 91.9%, the CSA W/F>1.4 positive 89.2%... 02 wrists abnormalities neurosurgeon 6%. Postoperatively the patients had clinical manifestations to immediately reduce, but the nerve median area decreased only after 3 months (p<0.05).

Conclusion: Ultrasonography has ability identify nerve median segments injured through the carpal tunnel and other injuries the wrist coordinated, simultaneously ultrasound tracking effective after surgical treatment tunnel syndrome wrists.

Keywords: Carpal tunnel syndrome.