Kiritsis P G, Kline S C
Department of Orthopedics, Eastern Virginia Medical School, Norfolk, USA.
J Hand Surg Am. 1995 Mar;20(2):173-80. doi: 10.1016/S0363-5023(05)80003-6.
We used a previously described cadaveric model for evaluating changes in flexor tendon biomechanics after open carpal tunnel release to evaluate endoscopic and step-cut lengthening techniques. A 26% and 18% increase in tendon excursion consumed by wrist motion was demonstrated for flexor digitorum profundus and flexor digitorum superficialis tendons respectively after open transection of the transverse carpal ligament. A 21% and 15% increase in tendon excursion was demonstrated after endoscopic carpal tunnel release and a 21% and 16% increase after step-cut lengthening of the transverse carpal ligament. Increased excursion was noted after 20-30 degrees of wrist flexion as tendon bowstringing occurred. Although division of the transverse carpal ligament by all methods resulted in a significant increase in tendon excursion, the differences between methods of carpal tunnel release were not significant. This cadaveric study evaluates one potential cause for weakness after carpal tunnel release, palmar displacement of the flexor tendons, which results in increased flexor tendon excursion consumed by wrist motion.
我们使用先前描述的尸体模型来评估开放性腕管松解术后屈肌腱生物力学的变化，以评估内镜和阶梯式延长技术。在横行腕横韧带开放性横断后，示指深屈肌腱和示指浅屈肌腱因腕关节活动而消耗的肌腱滑动分别增加了26%和18%。在内镜下腕管松解术后，肌腱滑动增加了21%和15%，在横行腕横韧带阶梯式延长术后增加了21%和16%。当腕关节屈曲20 - 30度出现肌腱弓弦样改变时，可观察到滑动增加。虽然所有方法切断腕横韧带均导致肌腱滑动显著增加，但腕管松解方法之间的差异并不显著。这项尸体研究评估了腕管松解术后无力的一个潜在原因，即屈肌腱向掌侧移位，这导致因腕关节活动而消耗的屈肌腱滑动增加。
