Ahcan Uros, Arnez Zoran M, Bajrović Fajko, Zorman Peter
University Department of Plastic Surgery and Burns, University Medical Centre, Ljubljana, Slovenia.
J Hand Surg Am. 2002 Sep;27(5):821-7. doi: 10.1053/jhsu.2002.35083.
A total of 379 patients (416 hands) with clinically diagnosed and electromyographically confirmed carpal tunnel syndrome were enrolled in a prospective study to determine the influence of a modified open decompression technique on postoperative scar discomfort. The new technique used in 184 patients (200 hands) is presented. Special attention was focused on identification and preservation of macroscopically detectable subcutaneous nerves. After using this method, which permits complete visualization of the entire transverse carpal ligament, the incidence of postoperative scar discomfort was 2.5%. This was significantly lower compared with the group of 195 patients (216 hands) treated by standard open decompression technique, without preservation of subcutaneous nerves. Primary results regarding relieving symptoms were comparable in both groups. Five anatomic variations of subcutaneous innervation, at the site of the incision in the line with the radial border of the ring finger, are described. The etiology of scar discomfort is discussed.
共有379例临床诊断并经肌电图证实为腕管综合征的患者（416只手）被纳入一项前瞻性研究，以确定改良开放式减压技术对术后瘢痕不适的影响。本文介绍了184例患者（200只手）所采用的新技术。特别关注了肉眼可见的皮下神经的识别和保留。使用该方法可完整观察整个腕横韧带，术后瘢痕不适的发生率为2.5%。这一发生率显著低于采用标准开放式减压技术且未保留皮下神经的195例患者（216只手）组。两组缓解症状的初步结果相当。本文描述了在与环指桡侧缘连线的切口部位皮下神经支配的五种解剖变异情况，并对瘢痕不适的病因进行了讨论。
