Resnick C T, Miller B W
University of Southern California School of Medicine, Los Angeles, California.
Contemp Orthop. 1991 Mar;22(3):269-77.
The surgical treatment for entrapment neuropathy of the median nerve in the carpal tunnel is varied. Recent publications have demonstrated a closed, endoscopic method for release of the carpal tunnel using a two-portal technique. In this report, a surgical technique for performing a subligamentous modification of this two-portal procedure is discussed, and the special tools used in this approach are demonstrated. In the early portion of this series of 75 symptomatic hands in 65 patients, 8% (6/75 hands) developed transient postoperative ulnar nerve neuropraxia. One patient experienced an iatrogenic laceration of the median nerve. Following the institution of the subligamentous approach, no postoperative nerve complications occurred. The majority of the patients experienced a significant decrease in their median nerve symptoms. This procedure has been found to be safe and is equally as effective as open surgical treatment of patients with carpal tunnel syndrome.
腕管综合征正中神经卡压的手术治疗方法多样。近期的文献报道了一种采用双入路技术的闭合式内镜下腕管松解方法。在本报告中，我们讨论了对该双入路手术进行韧带下改良的手术技术，并展示了该方法中使用的特殊工具。在这组由65例患者的75只症状性手部组成的病例系列的早期阶段，8%（6/75只手）出现了术后短暂性尺神经失用症。1例患者发生了医源性正中神经撕裂伤。采用韧带下手术方法后，未出现术后神经并发症。大多数患者的正中神经症状明显减轻。已发现该手术方法安全，且对于腕管综合征患者，其疗效与开放性手术治疗相当。
