Wongsiri Sunton, Suwanno Porames, Tangtrakulwanich Boonsin, Yuenyongviwat Varah, Wongsiri Ekkarin
Department of Orthopaedic Surgery and Physical Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
BMC Musculoskelet Disord. 2008 Sep 22;9:126. doi: 10.1186/1471-2474-9-126.
Mini-open carpal tunnel release has become increasingly popular for the treatment of carpal tunnel surgery. The main advantages are shortening recovery time and return-to-work time. However, the risk of neurovascular injury still remains worrisome.
In this study, we developed a new retractor (herein called the PSU retractor) modified from the widely used Senn retractor, with the aim of decreasing the risk of neurovascular problems from normal procedure. 3-Dimensional computer design software (SolidWorks Office Premium 2007 SP3.1) was used to construct a 3-D PSU retractor prototype. An amputated arm from a 30-year-old woman diagnosed as synovial sarcoma at the shoulder was used to test the maximal visual length. A mini-surgical incision was performed at 3 cm distal to the transverse wrist crease and a tiny flexible ruler was inserted through the tunnel beneath the skin to measure the maximal visual length.
Our new retractor showed significantly better maximal visual length compared to the Senn retractor (47.7(8.1) mm vs. 39.2(6.5) mm). In addition, most assessors expressed a higher satisfaction rate with the PSU retractor than with the Senn retractor (7.3 (1.9) vs. 6.3 (1.1)).
In conclusion, we have developed a promising new retractor using a computer design program, which appears to be an improvement on the currently available equipment used for mini-open carpal tunnel surgery. However, further clinical studies are needed to confirm our initial findings.
小切口腕管松解术在腕管手术治疗中越来越受欢迎。其主要优点是缩短恢复时间和重返工作岗位的时间。然而，神经血管损伤的风险仍然令人担忧。
在本研究中，我们对广泛使用的森氏牵开器进行改良，开发了一种新型牵开器（以下称为PSU牵开器），目的是降低常规手术中神经血管问题的风险。使用三维计算机设计软件（SolidWorks Office Premium 2007 SP3.1）构建PSU牵开器的三维原型。使用一名30岁女性因肩部滑膜肉瘤而截肢的手臂来测试最大可视长度。在腕横纹远端3 cm处做一个小手术切口，并通过皮肤下的隧道插入一个微小的柔性尺来测量最大可视长度。
与森氏牵开器相比，我们的新型牵开器显示出明显更好的最大可视长度（47.7(8.1)mm对39.2(6.5)mm）。此外，大多数评估者对PSU牵开器的满意度高于森氏牵开器（7.3(1.9)对6.3(1.1)）。
总之，我们使用计算机设计程序开发了一种有前景的新型牵开器，它似乎是对目前用于小切口腕管手术的现有设备的一种改进。然而，需要进一步的临床研究来证实我们的初步发现。
