Hebbard Peter D, Hebbard Andrew I T, Tomka Janos, Appleyard Richard
University of Melbourne, Northeast Health Wangaratta, Wangaratta, Victoria, Australia.
St Vincent's Hospital, Melbourne, Victoria, Australia.
J Ultrasound Med. 2018 Aug;37(8):2075-2081. doi: 10.1002/jum.14549. Epub 2018 Feb 16.
Ultrasound (US)-guided microinvasive procedures are defined as those performed via needles without notable scarring. Ten cadaver hands underwent US-guided microinvasive carpal tunnel release using a novel needle-based tool, the micro i-Blade (Summit Medical Products, Inc, Sandy, UT). A US-imaged landmark, the inflexion point of the ligaments distal to the hook of the hamate, was used to position the distal extent of the cut. The transverse carpal ligament was successfully released in all hands without damage to nerves or arteries. In 3 specimens, the fascia between the thenar and hypothenar muscles was partly preserved, whereas the palmar aponeurosis was partly cut in 1 specimen. The micro i-Blade with the cutting knife retracted was also useful as a probe palpated through the palm of the cadaver hand, to test the release of the transverse carpal ligament and to guide the procedure.
超声(US)引导下的微创操作是指通过针进行且不会留下明显疤痕的操作。十具尸体手使用一种新型的基于针的工具——微型i刀片(Summit Medical Products, Inc, Sandy, UT),接受了超声引导下的微创腕管松解术。一个超声成像的标志,即钩骨钩远端韧带的拐点,被用于确定切口的远端范围。所有尸体手的腕横韧带均成功松解,且未损伤神经或动脉。在3个标本中,大鱼际肌和小鱼际肌之间的筋膜部分得以保留,而在1个标本中,掌腱膜被部分切断。缩回切割刀后的微型i刀片也可作为探针,通过尸体手的手掌进行触诊,以测试腕横韧带的松解情况并指导操作。