Jin Guo-Qiang, Yang Jun, Li Chun-You, Ming Xiao-Feng, Zhao Xiao-Fei, Cheng Chun-Sheng
Department of Hand Surgery and Microsurgery, Luoyang Orthopedic-Traumatological Hospital of Henan Province, Luoyang 471002, Henan, China.
Zhongguo Gu Shang. 2012 Jan;25(1):58-61.
To introduce the method of the transverse carpal ligament (TCL) transection through palmar mini-incision for carpal tunnel syndrome (CTS) and evaluate its efficacy and safety.
From January 2006 to September 2007, 15 patients (18 hands) with CTS were treated with palmar longitudinal mini-incision decompression. There were 2 males and 13 females, with an average age of 48 years (ranged 34 to 69) and an average course of 18 months (ranged 8 to 26). The main clinical symptom including the radial numbness or pain of the 3 and a half fingers, wrist pain and radiation to the forearm, the night awake history of numbness, thenar muscle atrophy, positive Tinel sign and Phalen sign. Median nerve electrophysiology showed that sensory nerve conduction velocity (SCV) slowed down and sensory nerve action potential (SNAP) decreased or missed, short abductor muscle of thumb had spontaneous potential in severe cases. Clinical effect were evaluated according to the Global symptom score (GSS) scoring in aspect of pain, numbness, paraesthesia, weakness and nocturnal awakening.
Postoperative wound smoothly healed in all patients and no complications occurred. All patients were followed up from 20 to 28 months with an average of 24 months. Symptoms of 1 patient had not incomplete relief, other patient's symptoms disappeared and muscle force of abductor pollicis brevis reinforced. Postoperative GSS scoring obviously improved than preoperative (P < 0.05).
Treatment of carpal tunnel syndrome through palmar mini-incision decompression has advantages such as higher safe, shorter operative time, less invasive, smaller scar, which can cut off carpi transversum ligament and thoroughly decompress median nerve under direct sight, it is a safe and effective operative approach.
介绍经手掌小切口切断腕横韧带治疗腕管综合征（CTS）的方法，并评估其有效性和安全性。
2006年1月至2007年9月，对15例（18只手）腕管综合征患者采用手掌纵行小切口减压治疗。其中男性2例，女性13例，平均年龄48岁（34～69岁），平均病程18个月（8～26个月）。主要临床症状包括桡侧3个半手指麻木或疼痛、腕部疼痛并向前臂放射、夜间麻木醒觉史、鱼际肌萎缩、Tinel征和Phalen征阳性。正中神经电生理检查显示感觉神经传导速度（SCV）减慢，感觉神经动作电位（SNAP）降低或消失，严重者拇短展肌有自发电位。根据全球症状评分（GSS）在疼痛、麻木、感觉异常、无力和夜间觉醒方面对临床疗效进行评估。
所有患者术后伤口均顺利愈合，无并发症发生。所有患者均随访20～28个月，平均24个月。1例患者症状未完全缓解，其他患者症状消失，拇短展肌肌力增强。术后GSS评分明显优于术前（P<0.05）。
经手掌小切口减压治疗腕管综合征具有安全性高、手术时间短、创伤小、瘢痕小等优点，能在直视下切断腕横韧带，充分减压正中神经，是一种安全有效的手术方法。
