Ueno H, Kaneko K, Taguchi T, Fuchigami Y, Fujimoto H, Kawai S
Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Ube, Japan.
Int Orthop. 2001;24(6):361-3. doi: 10.1007/s002640000189.
We investigated the outcome of endoscopic carpal tunnel release (ECTR) for patients with carpal tunnel syndrome (CTS) in comparison with the results of preoperative nerve conduction studies. The compound muscle action potential (CMAP) of the abductor pollicis brevis muscle (APB) and the second lumbrical muscle (L2) was recorded following median nerve stimulation at the wrist. A total of 38 hands in 35 patients were classified into four categories. Hands with a similarly prolonged distal motor latency for the APB and L2 were classified as type I (n=25), while those with a more prolonged distal motor latency for the APB than for the L2 (>0.7 ms) were classified as type 2 (n=10). Hands with a CMAP for the APB, but not L2, were classified as type 3 (n=1), and hands with no CMAP for either the APB or L2 were classified as type 4 (n=2). After ECTR, all of the type 1 and 2 hands were improved. Patients with type 3 and type 4 hands did not show satisfactory improvement, which may have been due to anatomical variation of the recurrent motor branch of the median nerve.
我们研究了腕管综合征（CTS）患者接受内镜下腕管松解术（ECTR）的结果，并与术前神经传导研究结果进行了比较。在腕部正中神经刺激后，记录拇短展肌（APB）和第二蚓状肌（L2）的复合肌肉动作电位（CMAP）。35例患者共38只手被分为四类。APB和L2的远端运动潜伏期同样延长的手被分类为I型（n = 25），而APB的远端运动潜伏期比L2延长更多（>0.7毫秒）的手被分类为2型（n = 10）。APB有CMAP但L2没有CMAP的手被分类为3型（n = 1），APB和L2均无CMAP的手被分类为4型（n = 2）。ECTR后，所有1型和2型手均有改善。3型和4型手的患者未显示出满意的改善，这可能是由于正中神经返支的解剖变异所致。
