Search

We conducted a prospective, randomized study to evaluate the effect of epineurotomy on the outcome of operative treatment of established median-nerve compression in the carpal canal. Fifty hands (forty-four patients) were randomized into two groups: one group had a release of the transverse carpal ligament alone, and the other had a release and adjuvant epineurotomy of the median nerve. The groups were similar with regard to age, gender, duration of symptoms, and preoperative physical findings. All patients had electrophysiological evidence of sensory delays and fibrillations on preoperative testing. All of the operative procedures were performed by the same surgeon. The patients were evaluated preoperatively and at one year postoperatively. The follow-up examination revealed no detectable differences between the two groups with regard to symptoms, objective findings, or electrophysiological findings. This suggests that epineurotomy of the median nerve offers no benefit compared with sectioning of the transverse carpal ligament alone.

Twelve children with lumbar-level myelodysplasia (average age, eight and three-quarter years) underwent twenty-one pelvic displacement osteotomies for subluxated or dislocated hips. Nineteen of the twenty-one hips remained reduced on three-year follow-up. Gains in gait pattern, ease of bracing, and reduced pelvic obliquity were noted. Active function about the hips was not improved, nor was there a decrease in the amount of bracing needed following the osteotomy. Pelvic displacement osteotomy can be utilized in selected cases as part of the over-all management of chronic hip dislocation in myelodysplasia.