Neumann A, Kponton T
Praxisklinik Orthopädie und Handchirurgie München West, Fürstenriederstr. 69-71, 80686, München, Deutschland.
Oper Orthop Traumatol. 2023 Jun;35(3-4):195-204. doi: 10.1007/s00064-023-00804-y. Epub 2023 Apr 25.
Decompression of the median nerve by complete endoscopic release of the transverse carpal ligament (TCL) and the distal antebrachial fascia. Minimization of surgical trauma results in decreased postoperative morbidity and earlier return to work and daily activities.
Symptomatic carpal tunnel syndrome.
Revision surgery after open or endoscopic procedure, rheumatic diseases.
Small transverse incision at the ulnar border of the palmaris longus tendon, and proximal to the distal wrist flexion crease. Exposure and incision of the antebrachial fascia, dilatation of the carpal tunnel and dissection of synovial tissue from the undersurface of the TCL. With the wrist in extension, the endoscopic blade assembly with integrated camera is inserted into the canal. Exposure of TCL and short incision in the middle portion. Gradually, dissection of the distal portion of the TCL then completion by retraction of the blade distally to proximally.
Slightly compressive dressing, selfcare on day 1 after procedure.
More than 25 years of experience, more than 8000 treated patients, and 3 documented cases with intraoperative lesions of the median nerve requiring revision. High acceptance and patient satisfaction in AQS1 patient-reported surveillance.
通过完全内镜下松解腕横韧带（TCL）和前臂远端筋膜来减压正中神经。将手术创伤降至最低可降低术后发病率，并使患者更早恢复工作和日常活动。
有症状的腕管综合征。
开放性或内镜手术后的翻修手术、风湿性疾病。
在掌长肌腱尺侧缘、腕关节远侧屈曲横纹近端做一小的横向切口。暴露并切开前臂筋膜，扩张腕管并从腕横韧带下表面剥离滑膜组织。在腕关节伸展位时，将带有集成摄像头的内镜刀片组件插入管内。暴露腕横韧带并在中间部分做一小切口。然后逐渐从前向后剥离腕横韧带远端部分，最后将刀片向近端牵拉完成操作。
轻度加压包扎，术后第1天开始自我护理。
超过25年的经验，治疗患者超过8000例，有3例记录在案的术中正中神经损伤病例需要翻修。在AQS1患者报告监测中患者接受度高且满意度高。
