Petrover David, Hakime Antoine, Silvera Jonathan, Richette Pascal, Nizard Rémy
Centre Imagerie Medicale Bachaumont Paris Centre (IMPC Bachaumont-Blomet Ramsay GDS), Paris, France.
Service de Rhumatologie, Hôpital Lariboisière, AP-HP, Paris, France.
Semin Intervent Radiol. 2018 Oct;35(4):248-254. doi: 10.1055/s-0038-1673360. Epub 2018 Nov 5.
Carpal tunnel syndrome (CTS) may be treated surgically if medical treatment fails. The classical approach involves release of the flexor retinaculum by endoscopic or open surgery. Meta-analyses have shown that the risk of nerve injury may be higher with endoscopic treatment. The recent contribution of ultrasound to the diagnosis and therapeutic management of CTS opens new perspectives. Ultrasound-guided carpal tunnel release via a minimally invasive approach enables the whole operation to be performed as a percutaneous radiological procedure. The advantages are a smaller incision compared with classical techniques; great safety during the procedure by visualization of anatomic structures, particularly variations in the median nerve; and realization of the procedure under local anesthesia. These advantages lead to a reduction in postsurgical sequelae and more rapid resumption of daily activities and work. Dressings are removed by the third day postsurgery. Recent studies seem to confirm the medical, economic, and aesthetic benefits of this new approach.
如果药物治疗无效，腕管综合征（CTS）可通过手术治疗。经典方法包括通过内镜或开放手术松解屈肌支持带。荟萃分析表明，内镜治疗时神经损伤的风险可能更高。超声在CTS诊断和治疗管理中的最新应用开辟了新的前景。超声引导下通过微创方法进行腕管松解，使整个手术能够作为经皮放射学手术进行。其优点包括与传统技术相比切口更小；通过可视化解剖结构，特别是正中神经的变异，手术过程中安全性高；以及在局部麻醉下进行手术。这些优点可减少术后后遗症，并更快恢复日常活动和工作。术后第三天即可拆除敷料。最近的研究似乎证实了这种新方法在医学、经济和美学方面的益处。
