Racasan O, Dubert T
Clinique La Francilienne, 77340 Pontault-Combault, France.
J Hand Surg Br. 2005 Aug;30(4):412-4. doi: 10.1016/j.jhsb.2005.04.009.
Steroid injections are routinely performed for carpal tunnel syndrome. Direct needle injury of the median nerve is the major complication of these injections. The safest location of the injection remains controversial. The purpose of this study is to define safe guidelines to avoid nerve injury. The distances between the Median nerve, Palmaris Longus, Flexor Carpi Ulnaris and Flexor Carpi Radialis tendons were measured pre-operatively, 1cm proximal to the distal wrist crease in 93 endoscopic carpal tunnel releases. We found that the median nerve extended ulnarly beyond the Palmaris Longus tendon in 82 hands (88%). It is concluded that the median nerve is at risk if the injection is performed within 1cm on either the ulnar or radial side of the Palmaris Longus tendon. More ulnarly, there is risk to the ulnar pedicle. The safest location is to inject through the FCR tendon.
类固醇注射常用于治疗腕管综合征。正中神经的直接针刺损伤是这些注射的主要并发症。注射的最安全位置仍存在争议。本研究的目的是确定避免神经损伤的安全指南。在93例内镜下腕管松解术中，于腕部远侧横纹近端1cm处术前测量正中神经、掌长肌、尺侧腕屈肌和桡侧腕屈肌腱之间的距离。我们发现，在82只手（88%）中，正中神经向尺侧延伸超过掌长肌腱。得出的结论是，如果在掌长肌腱尺侧或桡侧1cm范围内进行注射，正中神经会有风险。更向尺侧时，尺侧蒂会有风险。最安全的位置是通过桡侧腕屈肌腱进行注射。
