关节镜镜视下行腕横韧带切开术

目的 介绍在关节镜镜视下行腕横韧带切开术治疗腕管综合的方法。方法 1999年3月以来，对15例（18侧）腕管综合征采用Chow两点法在关节镜镜视下行腕横韧带切开术。腕管入口位于腕横纹近端2－3cm，掌长肌腱尺侧缘。腕关节背伸位时，将带槽套管自腕管入口处对准第3指蹼方向插入，从腕管远端穿出。在关节镜监控下用钩刀切开腕横韧带。结果 术后随访2－16上月，平均7个月。术后桡侧3指半的感觉已恢复正常。3例有拇指对掌功能和大鱼际肌萎缩者，术后3－6个月均恢复正常。无血管神经损伤和感染等并发症发生。结论 关节镜镜视下切开腕横韧带治疗腕管综合征是安全有效的微创手术。

Arthroscopic releasing of transverse carpal ligament

Objective To introduce the procedure for arthroscopic releasing of transverse carpal ligament for treatment of carpal tunnel syndrome.Methods Since March 1999,15 cases(18 sides) with carpal tunnel syndrome were treated by endoscopical releasing of transverse carpal ligament according to Chow's two portal method. The entry portal was inserted at 2 3 cm proximal to the transverse carpal crease, ulnar to the the palmaris longus. When the fingers and wrist in full extensionn ,the trocar was inserted at the entry of the wrist at the line of the third digital web and pull out at the distal carpal tunnel. Using the retrograde and forward knife transverse carpal ligament was completely released. Results Postoperative follow up ranged from 2 to 6 months(average 7 months). Numbness and pain disappeared at one to three days after operation on all cases. The greater thenar atrophy and opposition dysfunction in 3 cases were restored to normal at postoperative 3 to 6 months. There was no neurovascular injuries and infections.Conclusion Endoscopic carpal tunnel release for carpal tunnel syndrome is a safe and efficient mini traumatic procedure.