Department of Orthopedic Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Clin Orthop Surg. 2023 Apr;15(2):318-326. doi: 10.4055/cios22223. Epub 2023 Mar 15.
Compared to the classic open technique, limited exposure techniques have the advantages of less scar pain, more grip and pinch strength, and earlier return to daily life. We evaluated the effectiveness and safety of our novel method of minimally invasive carpal tunnel release using a hook knife through a small transverse carpal incision.
This study included 111 carpal tunnel decompressions in 78 patients who underwent carpal tunnel release from January 2017 to December 2018. We performed carpal tunnel release using a hook knife through a small transverse incision just proximal to the wrist crease under local infiltration of lidocaine with tourniquet inflation in the upper arm. All patients were tolerable during the procedure and discharged following the procedure on the same day.
At an average of 29.4 months of follow-up (range, 12-51 months), all but one patient (99%) revealed complete or near complete symptomatic recovery. The average of the symptom severity score on the Boston questionnaire was 1.31 ± 0.30 and the average of the functional status score was 1.19 ± 0.26. The final mean Quick Disabilities of the Arm, Shoulder, and Hand questionnaire (QuickDASH) score was 8.66 (range, 2-39). There was no superficial palmar arch injury or nerve injury of the palmar cutaneous branch, recurrent motor branch, or median nerve itself as a complication of the procedure. No patient showed any wound infection or wound dehiscence.
Our carpal tunnel release using a hook knife through a small transverse carpal incision performed by an experienced surgeon is a safe and reliable method that is expected to have the benefits of simplicity and minimal invasiveness.
与经典的开放式技术相比，有限暴露技术具有疤痕疼痛少、抓握和捏力更强、更早恢复日常生活等优点。我们评估了通过小的腕横切口使用钩刀微创腕管松解术的有效性和安全性。
本研究纳入了 2017 年 1 月至 2018 年 12 月期间接受腕管松解术的 78 例患者的 111 例腕管松解术。我们通过小的腕横切口（位于腕横纹近端）使用钩刀，在臂部充气止血带进行局部浸润麻醉下进行腕管松解。所有患者在手术过程中均能耐受，并在同一天手术后出院。
平均随访 29.4 个月（范围 12-51 个月），除 1 例患者（99%）外，所有患者均完全或几乎完全症状缓解。波士顿问卷的症状严重程度评分为 1.31 ± 0.30，功能状态评分为 1.19 ± 0.26。最终平均 Quick Disabilities of the Arm, Shoulder, and Hand 问卷（QuickDASH）评分为 8.66（范围 2-39）。该术式无正中神经掌皮支、返支运动支和正中神经本身的浅表掌弓损伤。无患者出现伤口感染或裂开。
由经验丰富的外科医生通过小的腕横切口使用钩刀进行的腕管松解术是一种安全可靠的方法，预计具有简单和微创的优点。
