Urbanski A, Spier W, Klinzing T, Aschoff J
Aktuelle Traumatol. 1986 Aug;16(4):137-42.
The carpal tunnel syndrome is described as a compression of the N. medianus under the retinaculum flexorum with the causes for this syndrome being of the most varied nature. The aetiology is multifactorial with frequent alterations of the connective tissue being observed in the histological specimen, i.e. chronic inflammatory proliferations or fibrotic degenerations. Direct pressure measurements have shown that the pressure is markedly higher both at rest and extension or flexion as compared to normal healthy subjects. An exact diagnosis requires a measurable prolongation of the distal motorial latency. Surgery is the treatment of choice to ensure perfect recovery. For this purpose the retinaculum flexorum must be entirely split, and our experiments have shown that the splitting of the epineurium yields good results. The microsurgical interfascicular neurolysis, however, should be considered in special cases only. Complaints tend to disappear fairly quickly in the majority of cases, i.e. pain recedes by 90%, sensitivity disorders by more than 70% and muscle atrophy by 50%. The operation enables a measurable improvement of the distal motorial latency. The incidence of postoperative complications is relatively low, and if they do occur, then they are negligible and without any bearing on the final surgical result. Persistent residual complaints are very often due to other accompanying diseases such as cervical vertebral column syndrome, cervical ribs etc.
腕管综合征被描述为屈肌支持带下正中神经受压,该综合征的病因多种多样。其病因是多因素的,在组织学标本中常观察到结缔组织的改变,即慢性炎症性增生或纤维化退变。直接压力测量表明,与正常健康受试者相比,无论是在休息时还是伸展或屈曲时,压力都明显更高。准确的诊断需要测量远端运动潜伏期延长。手术是确保完美恢复的首选治疗方法。为此,必须完全切开屈肌支持带,我们的实验表明,切开神经外膜会产生良好的效果。然而,显微外科束间神经松解术仅应在特殊情况下考虑。在大多数情况下,症状往往会相当迅速地消失,即疼痛减轻90%,感觉障碍减轻70%以上,肌肉萎缩减轻50%。手术能使远端运动潜伏期得到可测量的改善。术后并发症的发生率相对较低,如果确实发生,那么它们可以忽略不计,并且对最终手术结果没有任何影响。持续性残留症状往往是由于其他伴随疾病,如颈椎病、颈肋等。