Muppavarapu Raghuveer C, Rajaee Sean S, Ruchelsman David E, Belsky Mark R
Hand Surgery PC, Newton-Wellesley Hospital, Tufts University School of Medicine, Newton, MA; and Department of Orthopaedic Surgery, Masachusetts General Hospital/Harvard Medical School, Boston, MA.
Am J Orthop (Belle Mead NJ). 2015 Nov;44(11):495-8.
Incomplete release of the transverse carpal ligament (TCL) and median nerve injury are complications of carpal tunnel release (CTR). In this article, we describe a modified mini-open release using a fine nasal turbinate speculum to aid in the proximal release with direct visualization of the proximal limb of the TCL and the distal volar forearm fascia (DVFF). The technique begins with a 2.5-cm palmar longitudinal incision, and standard distal release of the TCL is completed. A fine nasal turbinate speculum is inserted into the plane above the proximal limb of the TCL and the DVFF. A long-handle scalpel is used to incise the TCL and the DVFF under direct visualization. We retrospectively analyzed a cohort of 101 consecutive CTR cases (63 right, 38 left). Carpal tunnel syndrome symptoms were relieved in all patients with a high degree of satisfaction. This modified mini-open technique provides surgeons with a reproducible and inexpensive method to ensure a safe proximal release of the TCL.
腕横韧带（TCL）松解不完全和正中神经损伤是腕管松解术（CTR）的并发症。在本文中，我们描述了一种改良的迷你开放松解术，使用精细的鼻甲骨窥器辅助近端松解，直接观察TCL近端和掌侧前臂远端筋膜（DVFF）。该技术始于一个2.5厘米的掌侧纵向切口，并完成TCL的标准远端松解。将精细的鼻甲骨窥器插入TCL近端和DVFF上方的平面。使用长柄手术刀在直接观察下切开TCL和DVFF。我们回顾性分析了连续101例CTR病例（63例右侧，38例左侧）。所有患者的腕管综合征症状均得到缓解，满意度很高。这种改良的迷你开放技术为外科医生提供了一种可重复且廉价的方法，以确保安全地进行TCL近端松解。
