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经手掌近侧小切口的腕管切开松解减压术
引用本文:张胜友,田光磊. 经手掌近侧小切口的腕管切开松解减压术[J]. 中华创伤骨科杂志, 2004, 6(10): 1194-1195
作者姓名:张胜友  田光磊
作者单位:1. 237006,安徽省六安市中医院骨科
2. 100035,北京市,北京积水潭医院手外科
摘    要:目的 报告使用手掌近侧小切口的腕管切开松解减压术的疗效。方法 自大、小鱼际纹交界处向远侧腕横纹做纵行切口,长2~2.5cm,直视下切开屈肌支持带,解除正中神经卡压。术后随访并与同期采用传统长切口的病例比较,观察小切口的疗效。结果 随访病例19例30腕,其中小切口6例11腕,长切口13例19腕,它们在手指麻木、腕痛、握力及两点辨别觉改善等方面无明显差异,在切口长度、手术时间、恢复正常生活与工作时间以及术后瘢痕触痛、墩柱部疼痛等方面,前者优于后者。结论 经手掌近侧小切口实施腕管切开松解减压术,较传统方法有更多优点,是一种安全、有效的治疗方法。

关 键 词:腕管综合征 正中神经卡压 神经损伤 腕管切开松解减压术
文章编号:1671-7600(2004)10-1194-02
修稿时间:2003-12-10

Carpal tunnel release via a short incision at the proximal palm of hand
Abstract:Objective To report the results of carpal tunnel release via a short incision at the proximal palm of hand. Methods A longitudinal incision 2 to 2.5 cm long was made from the junction of the thenar and hypothenar creases to the distal wrist crease. The retinaculum was cut under direct visualization to relieve the median nerve compression. Patients receiving carpal tunnel surgery were randomized to receive short incision open release or traditional long incision open release. Comparisons between the 2 releases were made after operation. Results 30 operations for 19 patients, including 11 short and 19 long incision open releases, were followed up. No significant differences were found between the 2 groups with respect to the improvements in finger numbness, wrist pain, grip strength, and two point discrimination. However, compared with the long incision group, the short incision group was superior in incision length, duration of operation, necessary time to resume normal activity and work, scar tenderness and pillar pain. Conclusion Carpal tunnel release via a short incision at the proximal palm of hand is a safe and effective method for carpal tunnel syndrome and has more advantages than the classical procedure.
Keywords:Carpal tunnel syndrome  Median nerve compression  Nerve injury
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