Abzug Joshua M, Jacoby Sidney M, Osterman A Lee
Department of Orthopaedics, University of Maryland School of Medicine, 1 Texas Station Ct., Suite 300, Timonium, MD 21093 USA.
Hand (N Y). 2012 Mar;7(1):23-9. doi: 10.1007/s11552-012-9391-7. Epub 2012 Jan 19.
Surgical release of the transverse carpal ligament for the treatment of carpal tunnel syndrome (CTS) is, in general, a very successful procedure. Some patients, however, fail this standard release and have persistent or recurrent symptoms. Such recalcitrance may relate to incomplete release but more often relates to perineural or intraneural fibrosis of the median nerve. While there is no good treatment for intraneural fibrosis, numerous procedures have evolved in an attempt to treat perineural fibrosis which restricts nerve gliding. These include procedures to isolate the nerve from scar as well as procedures to bring neovascularization to the median nerve. This review describes the various surgical treatment options for recalcitrant CTS as well as their reported outcomes.
一般来说，手术松解腕横韧带治疗腕管综合征（CTS）是一种非常成功的手术。然而，一些患者在这种标准松解手术后效果不佳，仍有持续或复发的症状。这种顽固性可能与松解不完全有关，但更常见的是与正中神经的神经周围或神经内纤维化有关。虽然对于神经内纤维化没有很好的治疗方法，但为了治疗限制神经滑动的神经周围纤维化，已经发展出了许多手术方法。这些方法包括将神经与瘢痕分离的手术以及使正中神经新生血管化的手术。本文综述了顽固性CTS的各种手术治疗选择及其报道的疗效。
