Berger R A, Bishop A T, Bettinger P C
Department of Orthopaedic Surgery and Anatomy, Mayo Clinic, Rochester, MN 55905, USA.
Ann Plast Surg. 1995 Jul;35(1):54-9. doi: 10.1097/00000637-199507000-00011.
A reliable, safe approach to the wrist through fiber-splitting dorsal capsulotomies has been developed. The dorsal wrist capsule is exposed by subperiosteally elevating the fourth and fifth extensor compartments ulnarly and translocating the extensor pollicis longus tendon with the radial wrist extensor tendons radially. The midcarpal joint and the radial half of the radiocarpal joint are exposed by longitudinally splitting the dorsal radiocarpal and dorsal intercarpal ligaments, with the apex at the triquetrum. The flap created is elevated radially, detaching the dorsal capsule from the radius to the level of the styloid process. For exposure of the ulnocarpal joint, the dorsal radiocarpal ligament is split longitudinally, and the capsule is incised along the extensor carpi ulnaris tendon subsheath proximally to the level of the triangular fibrocartilage, with the apex at the triquetrum. The flap created is elevated proximally. Exposure of the wrist is excellent, stability of the carpal bones is maintained, and closure is simplified using this approach.
已经开发出一种通过纤维劈开背侧关节囊切开术进入腕部的可靠、安全方法。通过在骨膜下向尺侧抬高第四和第五伸肌间隔并将拇长伸肌腱与桡侧腕伸肌腱一起向桡侧移位来暴露腕背侧关节囊。通过纵向劈开背侧桡腕韧带和背侧腕骨间韧带（顶点位于三角骨）来暴露腕中关节和桡腕关节的桡侧半。形成的皮瓣向桡侧掀起，将背侧关节囊从桡骨分离至茎突水平。为了暴露尺腕关节，纵向劈开背侧桡腕韧带，并在尺侧腕伸肌腱鞘下沿近端切开关节囊至三角纤维软骨水平（顶点位于三角骨）。形成的皮瓣向近端掀起。使用这种方法，腕部的暴露良好，腕骨的稳定性得以维持，并且关闭操作得以简化。
