Hutting Kor H, van Uchelen Jeroen H
Department of Plastic Surgery, Isala Klinieken Zwolle, Zwolle, The Netherlands.
Department of Plastic Surgery, Isala Klinieken Zwolle, Zwolle, The Netherlands.
J Hand Surg Am. 2018 Jul;43(7):686.e1-686.e5. doi: 10.1016/j.jhsa.2018.03.006. Epub 2018 Apr 24.
Surgical treatment of recurrent and persistent carpal tunnel syndrome by repeat carpal tunnel release combined with soft tissue nerve coverage results in a higher success rate for symptomatic relief in the presence of a scarred median nerve. Several techniques, including local pedicled flaps, transposition flaps from the distal forearm, and free flaps, have been described, but consensus regarding a preferred technique has not been reached. The dorsal ulnar artery flap or Becker flap is a local fasciocutaneous flap based on a dorsal perforating branch of the ulnar artery that can be used for soft tissue coverage of the median nerve. Advantages of this technique are the quick and easy dissection and low donor site morbidity. Studies of its use for the treatment of recurrent carpal tunnel syndrome are limited.
通过重复腕管松解术结合软组织神经覆盖术来治疗复发性和持续性腕管综合征，对于存在瘢痕化正中神经的患者，其症状缓解成功率更高。已经描述了几种技术，包括局部带蒂皮瓣、前臂远端转位皮瓣和游离皮瓣，但尚未就首选技术达成共识。尺背动脉皮瓣或贝克尔皮瓣是一种基于尺动脉背侧穿支的局部筋膜皮瓣，可用于正中神经的软组织覆盖。该技术的优点是解剖快速简便，供区并发症少。其用于治疗复发性腕管综合征的研究有限。
