掌部小切口治疗腕管综合征

目的介绍应用新型掌部小切口行腕管松解术。方法对确诊为腕管综合征的68例(89侧)患者采用新型掌部小切口行腕管松解术,该切口为纵行、位于鱼际纹尺侧2～3mm、长约2.0～2.5cm,近端不超过远侧腕横纹。结果经术后6个月随访,所有患者症状均消失,拇短展肌肌力、握力、捏力、皮肤感觉功能均明显改善,术前术后差异在统计学极具显著意义(P<0.001)。本组无任何神经血管并发症,无1例出现腕掌部瘢痕疼痛。结论本切口具有安全、损伤小、直视下松解腕管并同时可行正中神经内松解和尺管松解、手术瘢痕小等诸多优点,是腕管松解术的一种新型、可靠的手术入路。

Mini palmar approach for carpal tunnel release

Objective To introduce a new palmar approach for carpal tunnel r el ease (CTR). Methods 89 hands in 68 cases who had been definitely diagnosed as ca rpal tunnel syndrome (CTS) were operated on by the new palmar approach for CTR. The short longitudinal incision, 2.0 to 2.5cm in length, was made from mid-palm to the most proximal portion of the palm, and was located 2 to 3mm on the ulnar side of thenar crease. It ended in the palm and did not extend to distal wrist crease. Results The follow-ups six months after surgery showed that all the pat ients were satisfied with complete relief of symptoms, obvious functional improv ement in strength, grip and pinch of abductor pollicis brevis (APB), Semmes-Wei nstein monofilament test and so on. The differences between pre-surgery functio ns and post-surgery ones were statistically significant (P< 0.001). Neither pil lar pain nor complications of nerve or blood vessels were found in the group of patients. Conclusions The mini palmar incision is a new and reliable surgical ap proach for CTR with many advantages. It is safer, less invasive, and causes only an inconspicuous scar. The transverse carpal ligament can be sectioned under di rect visualization so that a neurolysis of the median nerve, even the canal of G uyon release, can be performed during the same procedure if necessary.