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超声引导下前臂骨间膜切断术。

Ultrasound-guided transection of the interosseous membrane of the forearm.

机构信息

Department of orthopedic surgery, École de Chirurgie, Assistance publique-Hôpitaux de Paris, 7, rue du Fer-à-Moulin, 75005 Paris, France.

Centre de la main échochirurgie de Versailles, 7bis, rue de la Porte-de-Buc, 78000 Versailles, France.

出版信息

Hand Surg Rehabil. 2020 May;39(3):167-170. doi: 10.1016/j.hansur.2020.01.008. Epub 2020 Feb 20.

Abstract

We sought to evaluate the feasibility of ultrasound-guided transection of the interosseous membrane of the forearm. The study involved ten forearms from five fresh cadavers. An ultrasound scanner (Toshiba™ Aplio V®, Toshigi, Japan) with a linear probe (Toshiba™ PLT-805AT 8Mhz) and a 25-cm long Kemis® knife (NewClip Technics™, Cholet, France), which was specially created for this study, were used. An approach to the distal and proximal radioulnar joint was made before the transection. The induced muscle hernia sign and the radius joystick test were performed to confirm the effectiveness of the ultrasound-guided transection. Complete dissection of the posterior surface of the forearm was done to check for complications and evaluate the quality of the transection. We registered nine complete transections of the interosseous membrane. The muscular hernia sign was present in all the cases performed. The joystick test was positive in eight cases. One forearm had a vascular complication. This ultrasound-guided interosseous membrane transection technique is feasible and effective with limited vascular and nerve risks. A prospective clinical study is required to validate this anatomical work.

摘要

我们旨在评估超声引导下前臂骨间膜切断术的可行性。该研究涉及五个新鲜尸体的十个前臂。使用了东芝 Aplio V®超声扫描仪(日本东芝)、线阵探头(东芝 PLT-805AT 8MHz)和专门为此研究设计的 25 厘米长的 Kemis®刀(法国 Cholet 的 NewClip Technics™)。在进行切断术之前,先对远侧和近侧桡尺关节进行了处理。进行了诱导性肌肉疝征和桡骨操纵杆试验,以确认超声引导下切断术的有效性。对前臂的后表面进行了完全解剖,以检查并发症并评估切断术的质量。我们记录了九例完全切断的骨间膜。在所有进行的病例中都存在肌肉疝征。在八例中,操纵杆试验为阳性。一例前臂发生血管并发症。这种超声引导下的骨间膜切断技术是可行且有效的,具有有限的血管和神经风险。需要进行前瞻性临床研究来验证这种解剖学工作。

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