Ohuchi Hiroshi, Hattori Soichi, Shinga Kotaro, Ichikawa Ken, Yamada Shin
Department of Sports Medicine, Kameda Medical Center, Kamogawa, Japan.
Arthrosc Tech. 2016 May 16;5(3):e483-7. doi: 10.1016/j.eats.2016.01.035. eCollection 2016 Jun.
Various surgical procedures for carpal tunnel syndrome exist, such as open release, ultrasound-guided percutaneous release, and endoscopic release. Postoperative pain, scarring, and slow recovery to normal function are reported complications of open release. Damage to vessels and the median nerve and its branches underlying the transverse carpal ligament is a reported complication of ultrasound-guided percutaneous release. Damage to the superficial palmar arch and incomplete release are reported complications of endoscopic release. By performing endoscopic carpal tunnel release with ultrasound assistance, we could visualize neurovascular structures directly with the endoscope and also indirectly with ultrasound to minimize complications. We could also evaluate the morphologic changes of the median nerve dynamically before and after the release. We discuss the technique for this procedure and outline pearls and pitfalls for success.
治疗腕管综合征的手术方法有多种，如开放式松解术、超声引导下经皮松解术和内镜松解术。据报道，开放式松解术的并发症包括术后疼痛、瘢痕形成以及恢复正常功能缓慢。据报道，超声引导下经皮松解术的并发症是损伤腕横韧带下方的血管、正中神经及其分支。据报道，内镜松解术的并发症是损伤掌浅弓和松解不完全。通过在超声辅助下进行内镜腕管松解术，我们可以直接通过内镜以及间接通过超声观察神经血管结构，以尽量减少并发症。我们还可以动态评估松解前后正中神经的形态变化。我们讨论了该手术的技术，并概述了成功的要点和陷阱。
