Shen Yifeng, Zhou Qiaoyin, Sun Xiaojie, Qiu Zuyun, Jia Yan, Li Shiliang, Zhang Weiguang
College of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
Urology Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Front Surg. 2023 Jan 6;9:1034716. doi: 10.3389/fsurg.2022.1034716. eCollection 2022.
This study aimed to compare the effectiveness and safety of the percutaneous first extensor compartment performed by acupotomy procedure with or without ultrasonic (US) guidance.
The percutaneous release was performed with an acupotomy on 40 wrists of cadavers, which was divided into US guidance operation and blind operation. Each arm was dissected and assessed regarding the amount of release and the extent of neurovascular and tendon injury. An analysis of finite biomechanical elements based on wrists specimen data is analyzed to observe the stress of the first extensor tendon compartment. A prospective study observed the pain visual analogue score(VAS) and Patient-Rated Wrist Evaluation (PRWEB) changes after the ultrasound guidance or blind acupotomy treatment in 30 dQD patients.
The success rate in the ultrasound-guided technique was 85%, and the blind technique was 70% in the cadaver study, both techniques without neurovascular injury. There was no statistically significant difference between the two groups in measuring the distance from the incision marks to the blood vessels and nerves ( > 0.05). According to the biomechanical analysis, the tendon friction rubs when the wrist is upright. When the wrist is flexed, the tendon and tendon sheath is stressed in the bone ridges. In this prospective study, both ultrasound guidance and blind acupotomy treatment achieved well improvements in pain and function ( < 0.05), but the results with no statistically significant between groups ( > 0.05).
Both blind and US-guided percutaneous release by acupotomy of the first extensor tendon compartment can get a good result. US-guided techniques can improve the success rate during acupotomy operations, especially for beginners and followers.
本研究旨在比较超声（US）引导下与非超声引导下经皮针刀治疗第一伸肌间隔的有效性和安全性。
对40具尸体的手腕进行经皮针刀松解，分为超声引导组和盲法组。对每只手臂进行解剖，评估松解量以及神经血管和肌腱损伤程度。基于手腕标本数据进行有限生物力学元素分析，以观察第一伸肌腱间隔的应力情况。一项前瞻性研究观察了30例患者在超声引导或盲法针刀治疗后30天内疼痛视觉模拟评分（VAS）和患者腕关节评估（PRWEB）的变化。
在尸体研究中，超声引导技术的成功率为85%，盲法技术为70%，两种技术均无神经血管损伤。两组在测量切口标记到血管和神经的距离方面无统计学显著差异（>0.05）。根据生物力学分析，手腕伸直时肌腱产生摩擦。手腕屈曲时，肌腱和腱鞘在骨嵴处受力。在这项前瞻性研究中，超声引导和盲法针刀治疗在疼痛和功能方面均有良好改善（<0.05），但组间结果无统计学显著差异（> 0.05）。
盲法和超声引导下经皮针刀松解第一伸肌腱间隔均能取得良好效果。超声引导技术可提高针刀手术的成功率，尤其对于初学者和跟随者。
