Open carpal release using local anesthesia without a tourniquet: Does bleeding tendency affect the outcome?

局部麻醉下不使用止血带进行腕关节开放松解术:出血倾向是否会影响手术结果?

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Abstract

BACKGROUND: The aim of this study was to analyze the clinical results of minimal single palmar-incision carpal tunnel release without a tourniquet. METHODS: We reviewed the medical records of 75 patients (90 cases of carpal tunnel syndrome) who underwent minimal single-palmar incision carpal tunnel release without a tourniquet from June 2010 to January 2018. Ten patients had a bleeding tendency. We compared the preoperative and postoperative Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) scores. We also analyzed outcomes and complications according to the presence of a bleeding tendency. RESULTS: In all cases, there was a complete disappearance or marked improvement in symptoms within 6 months, with no recurrence. The postoperative BCTQ score showed a significant improvement compared to the preoperative score, and no statistically significant difference in BCTQ scores was detected according to the presence of a bleeding tendency. CONCLUSIONS: Carpal tunnel release without a tourniquet using a minimal single palmar incision is effective and reliable. This technique prevents unnecessary pain associated with the tourniquet and is especially helpful in patients with a bleeding tendency or those treated with hemodialysis.

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