腕关节镜检查使用 2R 入路：比 1,2 入路更安全吗？
Wrist Arthroscopy Using the 2R Portal: Is It Safer Than the 1,2 Portal?
机构信息
Mayo Clinic, Rochester, MN, USA.
出版信息
Hand (N Y). 2023 Jul;18(5):746-750. doi: 10.1177/15589447221075668. Epub 2022 Feb 10.
BACKGROUD
The purpose of this study was to compare the 1,2 with a novel 2R portal in terms of proximity to critical structures.
METHODS
Wrist arthroscopy was performed on 8 fresh frozen cadavers via the 1,2 and 2R portals. External anatomy was then dissected under loupe magnification. The closest distance between the portals and surrounding anatomical structures was measured in millimeters using digital calipers.
RESULTS
The 1,2 portal was significantly closer to radial artery and first extensor compartment tendons than the 2R portal. The radial artery was on average 1.32 mm from the 1-2 portal and 14.25 mm from the 2R portal. The 2R portal was significantly closer to the second and third extensor compartment tendons. The closest branch of the superficial branch of the radial nerve (SBRN) was on average 2.04 mm from the 1-2 portal and 7.59 mm from the 2R portal, but this was not statistically significant.
CONCLUSIONS
We advocate using the 2R portal preferentially to the 1,2 portal when treating radial sided wrist pathology to decrease the risk of iatrogenic radial artery and SBRN injury.
背景
本研究旨在比较 1,2 入路与新型 2R 入路在临近关键结构方面的差异。
方法
通过 1,2 和 2R 入路对 8 例新鲜冷冻尸体进行腕关节镜检查。然后在放大镜下解剖外部解剖结构。使用数字卡尺测量入路与周围解剖结构之间的最短距离（以毫米为单位）。
结果
1,2 入路与桡动脉和第一伸肌间隔肌腱的距离明显比 2R 入路更近。桡动脉距 1-2 入路平均为 1.32 毫米，距 2R 入路平均为 14.25 毫米。2R 入路与第二和第三伸肌间隔肌腱的距离更近。桡浅神经（SBRN）的最接近分支距 1-2 入路平均为 2.04 毫米，距 2R 入路平均为 7.59 毫米，但无统计学意义。
结论
我们主张在治疗桡侧腕部病变时优先使用 2R 入路，而不是 1,2 入路，以降低医源性桡动脉和 SBRN 损伤的风险。
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