Clinical features and surgical treatment of combination of pronator teres syndrome and carpal tunnel syndrome

Abstract

Objective: To determine the effectiveness of surgical interventions aimed at decompression of the median nerve (MN) in the carpal tunnel and pronator teres canal, in combination with carpal tunnel syndrome (CTS) and pronator teres syndrome (PTS). Materials and methods: The results of surgical treatment of patients with a combination of CTS and PTS were analyzed, a total of 20 observations. The analysis of the results was evaluated according to: the Boston Questionnaire (BCTQ), namely, symptoms severity scale - SSS (minimum 1 point, maximum 5 points) and functional severity scale - FSS (minimum 1 point, maximum 5 points), the Bishop Score, visual analogue scale (VAS). Results: All operated patients (100%) experienced a significant regression of the main manifestations of the disease on the first day after the operation. Paresthesia in the fingers of the hand decreased, the sensitivity in the MN dermatome improved significantly, and sleep improved. The average indicators after surgery on symptoms severity scale (SSS) were 1.3 points, on functional severity scale (FSS) - 1.4 points, visual analogue scale - 2 points. The assessment of treatment results according to the Bishop Score in the postoperative period, that is, at the time of discharge (3 days after surgery), was an average of 10 points. Conclusions: Decompression of the MN in the area of the carpal tunnel and pronator teres is an effective method of treatment for the combination of CTS and PTS. A positive effect in the form of a regression of pain syndrome, sensitivity disorders and an increase in strength in the hand is observed already in the early postoperative period. Scores on BCTQ and VAS improve by more than 50%.