Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: General Orthopaedics
Abstract number: 24496
CARPEL TUNNEL SYNOVECTOMY: DOES CLINICAL ABNORMALITY
CORRESPOND WITH HISTOLOGICAL ABNORMALITY?
Uthman ALAO 1 , Odharnaith O'BRIEN 2 , Tara J BROWNE 2 , Babiker SULIMAN 1 ,
Parick FLEMING 1
1 Department of Trauma & Orthopaedics, Cork (IRELAND), 2 Departent of
Histopathology, Cork (IRELAND)
Background: Fibrous thickening of the flexor tendon synovium is a common finding
during carpel tunnel decompression. This is generally accepted to be tenosynovial
fibrosis. The aim of this study is to determine whether clinical appearance of
abnormality corresponds to histological abnormality. Method: We retrospectively
identified 49 wrists in 47 patients who underwent flexor tendon synovectomy during
treatment for carpel tunnel decompression. The indication for synovectomy was
clinical abnormality of the synovium intra-operatively. Histological reports were
examined to determine whether histological abnormality corresponded with clinical
abnormality. A post-operative functional outcome score from patients who underwent
synovectomy and open decompression (group 1) was compared to patients who
underwent decompression alone (group 2). Complication rates between the groups
were compared. Results: Of the 49 slides analysed, inflammation was present in
10.1% (5) only. Oedema was present in 51% (25). The most common finding was
vascular scelerosis of small to medium sized vessels within the synovium in 77.1%
(38). The most infrequent findings were fibrosis and synovial hyperplasia 4% (2) and
2% (1) respectively. The mean functional outcome score for group 1 was 10 and 11.7
for group 2. Statistically analysis showed the difference was insignificant (p 0.065).
The complication rates between the two groups were equal. Conclusion: Clinical
abnormality is a poor predictor of histological appearance of tenosynovitis. Functional
outcome score suggest that synovectomy for clinical abnormality confers no greater
advantage but does not cause harm either. it may not be cost effective when done for
this reason alone.
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