Échographie du nerf médian

Cost-Effectiveness of Sonography-Guided Surgery

Percutaneous carpal tunnel release (CTR) is a new surgical technique allowing to cut the transverse carpal ligament under sonography, without skin incision. The technique is safe, offers good functional results and early return to daily activities. This study investigates if percutaneous CTR is also cost-effective. Percutaneous CTR presents many advantages and may be safer than open and endoscopic CTR. This study could not demonstrate that it allows also cheaper surgery, at least as compared to open CTR. However, if it allows earlier return to work, percutaneous CTR could offer a major economic advantage over other techniques, particularly open surgery.

Musculoskeletal interventional ultrasonography: the upper limb

Forty percent of the 823 ultrasound-guided injections performed in our centre over a year and a half concerned the upper limb, injections involving the shoulder, for subacromial bursitis and the treatment of calcific tendinitis, being the prime indications (24%). The wrist represented 8% of the prescriptions, for treatment of tendinopathy, ganglion cysts, carpal tunnel syndrome and rhizarthrosis. Trigger finger, tenosynovitis and pulley ganglia made up 6% of the indications and the elbow 2.5%. Ultrasound improves the accuracy of the procedure by helping guide the path of the needle and allowing the distribution of the substance injected to be visualised. We shall give details of the technique used for each indication, with advice and hints and post-procedure recommendations.