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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(05): 718-725
DOI: 10.1055/s-0040-1713759
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Fatores de insucesso do tratamento cirúrgico da síndrome do túnel do carpo: Quando e como revisar a cirurgia de descompressão do túnel do carpo

Article in several languages: português | English
Carlos Henrique Fernandes 
1   Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
João Baptista Gomes dos Santos 
1   Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
Francisco Schwartz-Fernandes 
2   USF Health Morsani College of Medicine, Tampa, Flórida, United States
,
A. Lee Ostermann 
3   Hand and Orthopaedic Surgery Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Flávio Faloppa 
1   Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
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Resumo

Apesar de ser um procedimento amplamente utilizado em todo o mundo e com elevadas taxas de remissão dos sintomas, o tratamento cirúrgico da síndrome do túnel do carpo pode apresentar resultados não satisfatórios ao paciente. Esse resultado não satisfatório pode se manifestar clinicamente pela não remissão dos sintomas, remissão dos sintomas mas recorrência desses após um período de tempo da cirurgia ou aparecimento de diferentes sintomas após a cirurgia. Diferentes fatores estão relacionados a esse insucesso do tratamento cirúrgico da síndrome do túnel do carpo (ITCSTC). A prevenção pode ser conseguida por meio de minuciosa avaliação clínica do paciente no período pré-operatório. Dessa forma o cirurgião poderá fazer diagnósticos diferenciais ou diagnósticos concomitantes, assim como identificar fatores ligados a insatisfação do paciente. Os fatores per-operatórios incluem a correta identificação das estruturas anatômicas para completa descompressão do nervo mediano. Inúmeros procedimentos têm sido descritos para o tratamento dos fatores que ocorrem no período pós-operatório. Desses o mais comum, a formação de aderências em torno do nervo mediano, tem sido tratado com relativo sucesso utilizando diferentes retalhos vascularizados ou cobertura com o uso de tecido autólogo ou homólogo. Descreveremos a abordagem do ITCSTC com maiores detalhes no texto.

Palavras-chave

síndrome do túnel do carpo/diagnóstico - síndrome do túnel do carpo/cirurgia - síndrome do túnel do carpo/complicações - recidiva - retalhos cirúrgicos


Publication History

Received: 20 December 2019

Accepted: 20 April 2020

Article published online:
22 September 2020

© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revinter Publicações Ltda
Rio de Janeiro, Brazil

 

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