Conner D E, Kolisek F R
Department of Surgery, University of Illinois College of Medicine, Peoria.
Orthop Rev. 1986 Jul;15(7):447-52.
The authors reviewed the median nerve decompressions performed by the senior author between 1976 and 1985 and found 787 surgical cases, of which 42 potentially occurred secondary to the use of vibration tools. All 42 patients presented with the classic history of carpal tunnel syndrome (CTS) and demonstrated a positive electromyography (EMG) or nerve-conduction study (NCS). Another six nonoperated patients with positive EMG or NCS were added to the group for a total of 48 patients with what the authors term vibration-induced carpal tunnel syndrome (VI-CTS). Of the 42 operated cases, 23 were bilateral, so a total of 65 median nerve decompressions are presented. Eight patients in the operated group also underwent incision of the flexor sheath for trigger fingers. The potential association between CTS or trigger finger and vibration syndrome is presented. The authors conclude that in the properly selected patient with VI-CTS, good subjective results can be obtained by median nerve decompression and/or trigger finger release.
作者回顾了资深作者在1976年至1985年间进行的正中神经减压手术,发现787例手术病例,其中42例可能继发于振动工具的使用。所有42例患者均有典型的腕管综合征(CTS)病史,并显示肌电图(EMG)或神经传导研究(NCS)呈阳性。另外6例EMG或NCS呈阳性的非手术患者被纳入该组,共有48例患者患有作者所称的振动性腕管综合征(VI-CTS)。在42例手术病例中,23例为双侧手术,因此共进行了65次正中神经减压手术。手术组中的8例患者还因扳机指接受了屈肌鞘切开术。文中介绍了CTS或扳机指与振动综合征之间的潜在关联。作者得出结论,对于经过适当选择的VI-CTS患者,通过正中神经减压和/或扳机指松解术可获得良好的主观效果。