腕管综合征24例报告

1964～1984年经治腕管综合征24例、男7例、女17例,平均年龄46.1岁、病史2月～3年半。经制动,理疗和局封三次共七次治疗无效者,计17例手术切除腕横韧带1～1.5cm,松解正中神经受压部粘连。术后13例在3天～3个月内功能恢复,4例2年后仍遗有轻度痛觉肌力减退。观察了腕管解剖学特征,并根据24例临床表现和诊治体会,认为夜间手术部痛、麻,正中神经普鲁卡因试验,有助于混淆诊断病例的鉴别。手术证明致病原因:肿瘤与囊肿6例,陈旧 Colles 骨折1例,腕横韧带肥厚或损伤疤痕增生4例腕管段屈指深、浅肌腱与腱鞘损伤粘连2例,腕舟骨骨折1例,原因不明3例。指出肿瘤致病率显著增高和多次局封的危害,认为初步保守治疗无效者,宜早期行腕管松解。对严重正中神经压迫者,行神经内显微松解术,有助于提高疗效。

Carpal Tunel Syndrome A Report of 24 Cases

From 1964 to 1984,the 24 Cases of carpal tunnel Syndrome were treated during twenty-one years.Among them female 7,male 17.The average age 46.1.Right carpal 15 cases, Left 4,double 5.The pcriod oftheedissease ranged from 2 months to 3.5 years. Seven cases were treated by immobilization,physiotherapy and 3 times of local seal.Seventeen cases who had long history and had got no progress with conservation were operated on to remove the carpi transversum Ligamenta and Loosen the adhere of median nerv.13 recovered functionally in three days to three months.4 remain a Little pain and the muscle weakness. The authors observated the anatomy Characterice of the carpal tunnel.According to the clinical findings and experience, They pointed the pain,senseless and the procaine test on median nerve were helpful in differenliation. The operation proved that the causes of the disease were tum- our and cyst 6 casas(one Sarcoma),old Colles fracture one case, hypertrophy of carpi transversum ligament or proliferation of injury scar 4 cases.Injury and adhere of the deep and superfial flexor and extensor tendons of fingers 2 cases,Fracture of the old carpal naviculare one case,Cause of were unclear. The authors,therefore,pointed the tumonr has distinguishing high and the dangerness of repeat of local seal asd prefer operating on the cases who had no progress woth conservative whose signs and symptoms are persistent and progressive,esp- ecially whose thenar atrophy,as early as possible division and remove of the deep transverse carpal ligament is indicated.Then the results of surgery wjll be advanced.For severe compressed the median nerve,microsurgery innerneuro is indicated.Thier results were advanced.