Spies Christian K, Unglaub Frank, Müller Lars P, Hahn Peter, Löw Steffen, Oppermann Johannes
Department of Hand Surgery, Vulpius Klinik, Vulpiusstraße 29, 74906, Bad Rappenau, Germany,
Arch Orthop Trauma Surg. 2015 May;135(5):737-41. doi: 10.1007/s00402-015-2207-9. Epub 2015 Apr 5.
The feasibility of endoscopically assisted decompression of the superficial radial nerve at the midportion and distal forearm was assessed.
After a 3 cm longitudinal skin incision at the Tinel's sign at the forearm, the subcutaneous tissue is dissected until forearm fascia is detected. The fascia is opened cautiously under direct visualization and the superficial radial nerve is identified. Blunt forceps mobilize the subcutaneous tissue upon the fascia before the illuminated speculum is inserted. Then further dissection of the fascia is performed proximally using the Metzenbaum scissors. After further blunt tunneling by forceps the endoscope is introduced proximally in order to release the superficial radial nerve completely. Then the speculum is inserted distally to identify the nerve within the subcutaneous tissue. Then further visualization is facilitated using the endoscope.
The endoscopically assisted release of the superficial radial nerve may be feasible in a safe and sufficient way.
评估了在前臂中部和远端经内镜辅助松解桡浅神经的可行性。
在前臂Tinel征处做一个3厘米的纵向皮肤切口,切开皮下组织直至前臂筋膜。在直视下小心打开筋膜并识别桡浅神经。在插入照明窥器之前,用钝头镊子将皮下组织从筋膜上分离。然后用梅氏剪刀向近端进一步切开筋膜。用镊子进一步钝性分离隧道后,将内镜向近端插入以完全松解桡浅神经。然后将窥器向远端插入以识别皮下组织内的神经。然后使用内镜便于进一步观察。
经内镜辅助松解桡浅神经可能是一种安全且充分的可行方法。