Introduction

Adolescent idiopathic scoliosis accounts for 80–85% of all lateral curvatures, and negatively affects pulmonary functions. The concave rib osteotomy technique is designed to provide additional mobility and flexibility of the spine, especially for rigid curves during correction. Only a few studies have investigated the effect of concave rib osteotomy on pulmonary functions.

Aims: To demonstrate that the double incision technique produces a signiþcant reduction in pillar pain and an earlier return to work. Methods: A randomised controlled trial of twenty-four patients (32 wrists), 18 wrists being allocated to the single incision group (S) and 14 to the double incision group (D), was carried out between 1996 and 1999, after clinical evaluation and complimentary EMG studies. Mean ages were 49.6 (32 to 69) and 45.8 (30 to 54) in the S and D groups respectively. Results: There was a difference in pillar pain in the two groups, being signiþcantly less in the D group (Chi-squared = 8.22) (P = 0.004). There were also differences in the return to work, being much less in Group D Ð Mean = 2.6 weeks (1 to 12) cf. 5.6 weeks (2 to 16). (Willcoxon Rank Sum Test P = 0.0004). There were no differences in the post-operative clinical symptoms (P > 0.05), scar sensitivity (Chi-squared = 1.025) (P = 0.506) or grip strength (P =0.506). The tourniquet time was longer for the double incision technique D = 15.3 minutes (12 to18) cf. S = 12.2 minutes (10 to 18). Conclusions: The Double incision technique is a simple and safe procedure for uncomplicated carpal tunnel syndrome, producing a signiþcant reduction in pillar pain and and earlier post-operative rehabilitation and an earlier return to work.

A randomised controlled trial involving 24 patients ( 32 wrists ), 18 wrists being allocated to the single incision group ( S ) and 14 to the double incision group ( D ), was carried out between 1996 and 1999, after clinical evaluation and complimentary EMG studies. Randomisation was performed by one of the orthopaedic secretaries using an envelope technique on the morning of admission. Mean ages were 49.6 ( 32 to 69 ) and 45.8 ( 30 to 54 ) in the S and D groups respectively. The male to female ratios were 2/12 and 5/7 respectively. The pre- and post-operative mass grip strength was measured by a Jamar dynanometer and assessment of post-operative parameters included pillar pain, scar sensitivity, nerve compression symptoms and return to work.

Pillar pain was significantly less in Group D ( Chi-squared = 8.22; P = 0.004 ).

Return to work was less in Group D ( average = 2.6 weeks ( 1 to 12 weeks )) cf. to Group S ( average = 5.6 weeks ( 2 to 16 weeks ) ). ( Wilcoxon Rank Sum Test P = 0.0004 ). No differences occurred in post-operative clinical symptoms ( P > 0.05 ), scar sensitivity ( Chi-squared = 1.025 ; P = 0.506 ) or mass grip strength ( P= 0.506 ).

The tourniquet time was longer for the double incision technique ( average = 15.3 minutes ( 12 to 18 minutes )) cf. to the single incision technique ( average = 12.2 minutes ( average = 10 to 18 minutes )).

The double incision technique is a safe and easy technique for uncomplicated carpal tunnel syndrome resulting in a significant reduction in pillar pain and a more rapid return to work.