Lee Chi Ho, Kim Taek Kun, Yoon Eul Sik, Dhong Eun Sang
Department of Plastic and Reconstructive Surgery, Korea University, Ansan Hospital, Ansan, Korea.
Ann Plast Surg. 2005 Feb;54(2):143-6. doi: 10.1097/01.sap.0000143799.88513.47.
The authors evaluated the morphologic changes that follow division of the transverse carpal ligament in patients with carpal tunnel syndrome (CTS) using high-resolution ultrasonography. Ten patients, for a total of 20 hands, underwent high-resolution ultrasonographic studies before the operation and 8 months after the operation. They were all diagnosed with bilateral idiopathic CTS. The authors evaluated the configuration of the median nerve and carpal tunnel at 3 different levels of the wrist: the distal radiocarpal joint level, the pisiform level, and the hook of hamate level. The median nerve gained in thickness to a remarkable extent at 2 distal levels after the operation. The change in morphology of the carpal tunnel at these 2 distal levels was obvious, but the cross-sectional area of the carpal tunnel was increased significantly only at the hook of hamate level. The transverse diameters of the carpal tunnel were not significantly changed. As mentioned, the authors found that the median nerve gained significantly in volume at the distal part of the carpal tunnel postoperatively, and the volumetric increase in the carpal tunnel appears to have resulted from an anterior displacement of newly formed transverse carpal ligament, rather than from a widening of the bony carpal arch.
作者使用高分辨率超声评估了腕管综合征（CTS）患者腕横韧带切断术后的形态学变化。10例患者共20只手，在手术前和手术后8个月接受了高分辨率超声检查。他们均被诊断为双侧特发性CTS。作者在腕部3个不同水平评估了正中神经和腕管的形态：桡腕关节远端水平、豌豆骨水平和钩骨钩水平。术后，正中神经在2个远端水平显著增厚。这2个远端水平腕管的形态变化明显，但仅在钩骨钩水平腕管横截面积显著增加。腕管的横径无明显变化。如前所述，作者发现术后腕管远端正中神经体积显著增加，腕管体积增加似乎是由于新形成的腕横韧带向前移位，而非骨性腕弓增宽所致。
