Estimation de la prévalence du syndrome du canal carpien au niveau de l’EPH de Laghouat

Abstract

Carpal tunnel syndrome is the most common root canal pathology in the general population. Carpal tunnel syndrome includes all the signs and symptoms related to compression of the median nerve during its passage through the carpal tunnel. The purpose of this work is to estimate the prevalence of carpal tunnel syndrome in the wilaya of Laghouat, to describe the place of the different therapeutic modalities and to assess the results of decompression of the median nerve at the wrist according to conventional techniques at the level of the traumatology department of the EPH of Laghouat. Material and methods : This is a retrospective study of 33 cases of carpal tunnel syndrome treated surgically using the conventional technique, in the traumatology department of the EPH of Laghouat during a period of 2 years, from January 2019 to December 2020. The prevalence of SCC in our study is 28%. The average age of the operated is 51 years and the female sex is predominant 76% compared to the men 24%. It is an idiopathic SCC in the majority of our patients (67%) with the presence of certain risk factors in some (obesity 9%, menopause 39%), while others present with secondary SCC (Diabetes 30%, Hypothyroidism 18% with renal failure 3%). 94% of our patients are right-handed, with a right SCC in 70%, left in 6% and bilateral in 24% of cases. The average duration of the evolution of the disease is 16 months with extremes ranging from 6 months to 3 years. Carpal tunnel syndrome was dominated by clinical signs: • Typical acroparesthesia in all our patients. • Pain in the territory of the median nerve which was reported by 23 patients (atypical in 3 patients). • Hypoaesthesia of the median nerve territory in 6 patients. • Decreased grip strength (paresis) in 5 patients. All our patients benefited from an electromyogram before being operated, and which confirmed damage to the median nerve at the level of the carpal tunnel. A standard X-ray of the face and profile wrist was made in all our patients; no abnormality was found. 3 patients in our study received corticosteroid infiltration (one infiltration in two patients and two infiltrations in another patient). All patients in our series used NSAIDs and analgesics for pain relief. 61% of patients in our series used a wrist rest splint at night. All the patients in our series were treated surgically using the conventional technique, consisting of opening and sectioning the anterior carpal ligament. All patients in our series were put on analgesics and anti-inflammatories postoperatively to relieve pain. The duration of hospitalization was on average 01 day. The results of the surgery were satisfactory for all our patients, with an immediate and complete almost total disappearance of pain and paresthesia’s. The appearance of late complications of CTS has been noted, including: 1 case of postoperative recurrence, 1 case of median nerve palsy and 1 case of neuroalgodystrophic sd. At the end of our work, we discussed the new perspectives of treatment other than surgery in order to be less aggressive and more effective whatever the stage of the evolution of the disease.