Department of Orthopaedic Surgery, HSC, The University of New Mexico, Albuquerque, NM.
Tech Hand Up Extrem Surg. 2023 Mar 1;27(1):9-13. doi: 10.1097/BTH.0000000000000401.
Severe thenar muscle atrophy resulting in dysfunctional thumb abduction and opposition is a well-documented finding associated with long-standing severe carpal tunnel syndrome. This problem has been addressed in the past through various opposition tendon transfers. Historically, the Camitz procedure, or its modifications using the palmaris longus tendon, were recommended. However, this procedure requires a long incision in the palm, extensive dissection including the wrist area, and may not produce active thumb pronation. Our surgical technique describes an open limited palmar-only carpal tunnel release with ring finger flexor digitorum superficialis opponensplasty using a slit through the released transverse carpal ligament as a pulley and dual insertion of the tendon in both the extensor hood and the tendon of the abductor pollicis brevis. The Kapandji evaluation of thumb opposition was used to determine the outcome after surgery.
严重的大鱼际肌萎缩导致拇指外展和对掌功能障碍是一种与长期严重腕管综合征相关的明确发现。过去，通过各种对掌肌腱转移术来解决这个问题。从历史上看，推荐使用 Camitz 手术或使用掌长肌腱的改良 Camitz 手术。然而，该手术需要在手掌上做一个长切口，广泛解剖包括腕部区域，并且可能无法产生主动的拇指旋前。我们的手术技术描述了一种开放性的、仅手掌的有限腕管松解术，使用通过松解的腕横韧带的一个狭缝作为滑轮，将食指屈指浅肌对掌成形术的肌腱双重插入伸肌鞘和拇短展肌的肌腱中。使用 Kapandji 拇指对掌评估来确定手术后的结果。
