| 内镜下两点单侧钩切法治疗腕管综合征的临床应用 |
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Received:April 03, 2007
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| 期刊信息：《中国骨伤》2008年21卷，第2期，第139-140页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的：探讨应用内镜的两点单侧钩切法切断腕横韧带，解除正中神经压迫的手术方法和疗效。
方法：临床治疗原发性11例13侧(左侧3例，右侧6例，双侧2例)43～68岁女性腕管综合征患者。全部患者均有桡侧3个半指的指端刺痛觉减退，腕部正中神经Tinel征阳性，11例大鱼际肌萎缩，同时4例存在拇指对掌功能减弱。术中局部麻醉，分别采取近侧腕横纹线处，掌长肌腱与桡侧屈腕肌腱之间1 cm皮肤横切口(入口)和患者拇指最大桡侧外展位，拇指尺侧平行线与中环指间的长轴线交叉点向尺侧1 cm处呈45°切口(出口).预制隧道后入口处置入腕关节镜，由出口插入钩刀。钩刀钩住腕横韧带近段后，内镜随钩刀移动而远行，全程镜视下由近及远切断腕横韧带。
结果：患者经随访4～20个月全部疗效满意，捏握功能明显改善。术后3个月时恢复至S3+ M3以上。无血管、神经或屈肌腱损伤等并发症。
结论：两点单侧钩切法操作步骤简单，是一种有效的手术方法。 |
| [关键词]:腕管综合征 内窥镜 外科手术，微创性 |
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| Clinical application of endoscopic two-portal one-way releasing procedure for carpal tunnel syndrome |
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Abstract:
Objective: To study the method and effect of endoscopic two-portal one-way releasing procedure for cut of transverse carpal ligament and decompression of median nerve.
Methods: Eleven female patients(13 sides)with primary carpal tunnel synrome underwent endoscopic two-portal one-way releasing procedure,there were 3 left hands,6 right,and 2 both. All the subjects had hypesthesia in the radial three and half finger,s tip with a positive,Tinel sign of median nerve at wrist;11 cases had thenar myatrophy in which 4 had opposition dysfunction. Under local anaesthesia,the proximal incision was located at the point of the proximal carpal transverse striation level between palmaris longus and flexor carpi radialis. The outlet was chosed the junction of the parallel line of the ulnar side of thumb and proximal extending line of middle ring fingers, long axis while the thumb was in abduction position. The length of each incision was only one centimeter. The hook knife was inserted to the proximate of the transverse carpal ligament,then,the transverse carpal ligament was completely released form the proximal to the distal end by hook knife under the endoscope monitor.
Results: The results showed that both pinch and grip function was satisfied and no complications occurred at 4 to 20 months followed-up. S3+ M3 or more has been reached in 3 months after operation.
Conclusion: The endoscopic two-portal one-way releasing procedure is an easy and effective method for the treatment of carpal tunnel synrome. |
| KEYWORDS:Carpal tunnel syndrome Endoscopes Surgical procedures,minimally invasive |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 张君,桑秋凌,李墨,赵文海.内镜下两点单侧钩切法治疗腕管综合征的临床应用[J].中国骨伤,2008,21(2):139~140 |
| 英文格式: | ZHANG Jun,SANG Qiu-ling,LI Mo,ZHAO Wen-hai.Clinical application of endoscopic two-portal one-way releasing procedure for carpal tunnel syndrome[J].zhongguo gu shang / China J Orthop Trauma ,2008,21(2):139~140 |
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