安全角引导小切口掌腱膜下腕横韧带切开治疗腕管综合征

目的　探讨在安全角引导小切口掌腱膜下腕横韧带切开治疗腕管综合征的临床疗效。 方法　自2015年6月~2018年6月，采用在安全角引导小切口掌腱膜下腕横韧带切开术，治疗腕管综合征105例，112侧，直视下正中神经外膜松解14侧。 结果　所有切口均一期愈合，手掌瘢痕轻微，无手术并发症。112 侧获得随访，时间6~24 个月, Kelly分级评定：优93侧，良15侧，一般4侧，优良率93.1 %。 结论　安全角引导小切口掌腱膜下腕横韧带切开是治疗腕管综合征理想的微创手术之一。术式简单、安全，能达到腕管减压，神经松解的治疗要求。

The sub-palmar aponeurotic transverse carpal ligament incision by the guidance of safe angle through a small incision

Objective The small incision sub-palmar aponeurotic transverse carpal ligament incision under the guidance of safe angle is a treatment of carpal tunnel syndrome. This article is aimed to discuss this treatment’s clinical therapeutic effect. Methods From June 2015 to June 2018, 105 cases (112 sides) of carpal tunnel syndrome were treated by small incision sub-palmar aponeurotic transverse carpal ligament incision under the guidance of safe angle. 14 sides had lysis of adventitia of median nerve under direct vision. Results All incisions had primary healing, the palm scars were mild, and no operative complications happened. We followed 112 sides after the surgery. The follow-up time was 6-24 months. Result showed that according to Kelly classification, 93 sides were ranked to excellent, 15 were good and 4 were fair. The excellent and good rate was 93.1%. Conclusions Small incision sub-palmar aponeurotic transverse carpal ligament incision under the guidance of safe angle is one of the ideal minimal invasive operations to treat carpal tunnel syndrome. This operation is simple, safe and can meet the needs of carpal tunnel decompression and neurolysis