腕管综合征的解剖学基础

目的：为临床行腕管内正中神经松解术治疗腕管综合征提供解剖学资料。方法：用局部解剖法在50侧上肢标本上观察并测量腕管、腕横韧带、正中神经和腕管内容物等解剖参数。结果：腕管的左右径、腕横韧带的长度、正中神经距腕横韧带的垂直距离、腕管及内容物的横断面积以及面积比等均是近侧端大过远侧端，而腕管的前后径、正中神经的径线、腕横韧带的厚度等则为近侧端小于远侧端。结论：腕管是一个缺乏伸展性的骨-韧带管道，任何因素卡压正中神经均可导致腕管综合征。在对患者做正中神经松解治疗时，保守注射疗法一般应在掌长肌腱内侧讲针．手术治疗时府在腕横韧带远侧端切开。

Anatomical Study on the Carpal Canal and Its Clinical Significance

s Objective:To provide anatomical data for the treatment of carpal tunnel syndrome.Methods:The carpal canal,transverse carpal ligament,median nerve and vertical distance of the nerve to ligament were dissected and observed on 50 sides of adult thoracic limb specimens.Results:The right-to-left diameter of the carpal canal,the length of the transverse carpal ligament,the vertical distance from the median nerve to the transverse carpal ligament,the transverse sectional area of the carpal canal, the contents and the area ratio at the proximal of the carpal canal were larger than those at the distal of the carpal canal.But the anterior-to-posterior diameter of the carpal canal,the diameter of the median nerve, and the thickness of the transverse carpal ligament at the proximal of the carpal canal were smaller than those at the distal of the carpal canal.Conclusion:The carpal canal is a bone-ligament canal.Any factors which can contract it or make its content expand will exert pressure on the median nerve and cause the carpal tunnel syndrome.When the patients are treated, the injection should be administered at the medial of median line,and the resection be performed at the distal of the transverse carpal ligament.