Introduction: : Adherence of the flexor tendons and severe scar of the median nerve can be reduced using the Chitosan Matrix as an adhesion barrier following mini open carpal tunnel release.
The objective was to investigate the potential benefits for complications ( Adherence of the flexor tendons and severing scarring involving the median nerve. )
Methods: PATIENT SAMPLES: The study cohort (Ch matrix group) consisted of consecutive patients (250 patients) who were treated with CH matrix. Patients in the standard procedure group (250 patients in all) were operated on prior to the adoption of matrix use by the surgeon.
OUTCOME MEASURES: Patients underwent carpal tunnel surgery same technique in both groups and completed follow-up evaluations at no less than 12 months post-operation.
clinical symptons
EMG studies
VAS questionare
Results: Numbness and paresthesias were relieved in 89% DG group and 86% in Control Group; pain was relieved in 89% DG and 86% CG. Motoric Weknes was relieved in 95% DG and 92 % CG. Normal grip strength was found in 93% DG and 91% had normal pinch strength.
Control group
Adhesion of the flexor tendons in 3 patients
5 patients had scarring of the median nerve
CH group
Recurrent pain : 1 patients for incomplete division of transverse carpal ligament
The difference in re-opration rate between the collagen matrix group and the standard procedure group is statiscally significant (P<0.01).
Conclusions: : Findings in this study (reduced pain and lower incidence of adhesions) are consistent with the Ch Matrix acting as an effective adhesion barrier.
Patient Care: aloow patients to become free of clinical symptoms after surgery
Learning Objectives: : A thorough knowledge of the anatomy of the carpal tunnel is essential in order to avoid complication and to ensure optimal patient outcome.
There are many strong arguments for open ( Short Incision 2.5 cm ) vs conservative treatment.
dural matrix is a good phisal barrier in order to avoid complications
carpal tunnel release. short incision. Ch dural matrix