Anatomic study of the volar single-aperture approach of endoscopic carpal tunnel release
WEI Rui-Hong, PENG Yong-Jing, XIE Feng-Qing, JIANG Gao-Li, XIONG Hong-Chao, FANG Ti-Che, ZHANG Han
Chinese Journal of Clinical Anatomy ›› 2015, Vol. 33 ›› Issue (1) : 12-16.
Anatomic study of the volar single-aperture approach of endoscopic carpal tunnel release
Objective To report the palmar approach and surgical method for the view to provide anatomical data for the volar single-aperture approach of endoscopic carpal tunnel release(ECTR). Methods 16 specimens of fresh adult upper limb were used to observe and measure the anatomical structures in the carpal tunnel and palm. 6 specimens of fresh adult upper limb were used randomly to simulate the operation that divided the flexor retinaculum and released the median nerve of ECTR by one-point technique in palm. Results The best entrance point in palm of ECTR: Draw a parallel line along the thumb in the maximal abduction position to the ulnar side, and draw a axis between the middle finger and the ring finger; Mark the intersection of the lines, and then take an incision in the ulnar aspect about 1cm away from the intersection. Surgical plane was the lacunar space between the superficial fascia and palmar aponeursis. Conclusion Our study confirms that ECTR by one-point technique in palm is safe and feasible. It’s practical for surgeons to adopt the surgical approach of ECTR and avoid damage during severance offlexor retinaculum and relief of the median nerve under endoscope.
The entrance point in palm / Minimally invasive treatment / Carpal tunnel syndrome / Anatomical studies
[1] Jimenez DF, Gibbs SR, Clapper AT. Endoscopic treatment of carpal tunnel syndrome:a critical review
[J].Neurosurg,1998，88(5):817-826.
[2] Mac Dermid JC, Wessel J. Clinical diagnosis of carpal tunnel syndrome:a systematic review
[J].Hand Ther, 2004, 7(2)：309-319.
[3] 顾玉东.重视对腕管综合征的诊治
[J].中国矫形外科杂志，2005, 13(5):325-326.
[4] Verdugo RJ, Salinas RA, Castillo JL, et al. Surgical versus non-surgical treatment for carpal tunnel syndrome
[J].Cochrane Database Syst Rev,2008, 4:551-552.
[5] Badger SA, ODonnell ME, Shengar JM, et al. Open carpal tunnel release: still a safe and effective operation
[J].Ulster Med，2008, 77(1):22-24.
[6] Aroori S，Spence RA. Carpal tunnel syndrome
[J].Ulster Med，2008, 77(1)：6-17.
[7] 赵宏，赵宇，田野，等. 腕管综合征关节镜下手术与开放手术的疗效比较
[J].中国医学科学院学报，2004, 26（6）：657-660.
[8] 史其林, 薛峰, 王金武, 等. 腕管综合征在内窥镜视下手术与常规手术的疗效比较
[J].中华手外科杂志，2000, 16(1):152-154.
[9] 姜晓琪，史其林，田东. 腕管综合征内镜手术预防正中神经损伤的临床研究
[J].中华现代外科学杂志，2010, 7（7）：398-400.
[10]史其林，桥诘博行，井上一. 在内窥镜下治疗腕管综合征45例报告
[J].中华手外科杂志，1997, 13(1)：22-24.
[11]Okutsu I, Ninomiya S，Natsuyama M，et a1．Subcutaneous operation and examination under universal endoscope
[J]．Jap Orthop Assoc，1987, 61(4)：491-498．
[12]Chow JCY．Endoscopic release of the carpal ligament for carpal tunnel syndrome：22-month clinical result
[J]．Arthroscopy，1990, 6(2)：288-296．
[13]孙贵新，史其林，郑宪友，等. Okutsu法与Chow法内窥镜下治疗腕管综合征的手术方法与疗效分析
[J]．中国内镜杂志，2004, 10(11)：28-31．
/
| 〈 |
|
〉 |
