Mathoulin C, Bahm J, Roukoz S
Institut de la Main, 6 square Jouvenet, 75016 Paris, France.
Hand Surg. 2000 Jul;5(1):33-40. doi: 10.1142/s0218810400000120.
We report the use of a hypothenar pedicled fat flap to cover the median nerve in recalcitrant carpal tunnel syndrome. Forty-five patients with recurrent symptoms after previous carpal tunnel surgery were included in this study. Patients with incomplete release of the transverse carpal ligament were not included. We performed an anatomical study on 30 cadavers. The original technique with the section of the deep branch of ulnar artery was modified. The flap could be transferred onto the median nerve without stretching. The median follow-up was 45 months (range, 12-80 months). Pain completely disappeared in 41 patients with normal nerve conduction. Based on clinical and electromyographic signs, the global results showed excellent results (49%), 19 good results (45%), two average results (4.5%) and two failures (2%). The use of a hypothenar pedicled fat flap to cover the median nerve in recalcitrant carpal tunnel syndrome is a simple and efficient technique which improves the trophic environment of the median nerve and relieves pain.
我们报告了使用小鱼际带蒂脂肪瓣覆盖顽固性腕管综合征中的正中神经。本研究纳入了45例先前腕管手术后出现复发症状的患者。未纳入腕横韧带松解不完全的患者。我们对30具尸体进行了解剖学研究。对尺动脉深支切断的原始技术进行了改良。该皮瓣可无张力地转移至正中神经上。中位随访时间为45个月（范围12 - 80个月）。41例神经传导正常的患者疼痛完全消失。根据临床和肌电图表现，总体结果显示优（49%）、良（19例，45%）、可（2例，4.5%）和差（2例，2%）。在顽固性腕管综合征中使用小鱼际带蒂脂肪瓣覆盖正中神经是一种简单有效的技术，可改善正中神经的营养环境并缓解疼痛。
