Shinya K, Lanzetta M, Conolly W B
Hand Units, St Luke's Hospital, New South Wales, Australia.
J Hand Surg Br. 1995 Apr;20(2):222-7. doi: 10.1016/s0266-7681(05)80056-7.
Single portal endoscopic carpal tunnel release was carried out in 107 hands of 88 patients. There were 11 complications. These included incomplete release (2), post operative scarring around the median and ulnar nerves (2), laceration of the superficial palmar arterial arch (1), reflex sympathetic dystrophy (2), palmar fasciitis (1), and wound inflammation (3). In two cases there was no relief of symptoms. In one there was incorrect diagnosis and in another, incorrect indication for endoscopic carpal tunnel release. The follow-up was from 3 to 18 months with an average of 6.8 months. The overall results of the patients in this series are being presented in another paper. Of the 107 procedures, 73 were rated as having an excellent, 25 good, three fair, and six poor results. The case of laceration of the superficial palmar arterial arch is discussed in detail in the paper. The two cases of reflex sympathetic dystrophy and the one case of palmar fasciitis had mild clinical features and resolved within 3 months. The inflammation in three of the wounds at the wrist resolved within 2 days of removal of the percutaneous sutures. These three patients had returned to heavy hand activities within a few days of surgery.
对88例患者的107只手实施了单通道内镜下腕管松解术。出现了11例并发症。其中包括松解不彻底(2例)、正中神经和尺神经周围术后瘢痕形成(2例)、掌浅动脉弓撕裂(1例)、反射性交感神经营养不良(2例)、掌腱膜炎(1例)以及伤口炎症(3例)。有2例症状未缓解。1例是诊断错误,另1例是内镜下腕管松解术的指征错误。随访时间为3至18个月,平均6.8个月。本系列患者的总体结果将在另一篇论文中呈现。在这107例手术中,73例结果评定为优秀,25例为良好,3例为一般,6例为差。本文详细讨论了掌浅动脉弓撕裂的病例。2例反射性交感神经营养不良病例和1例掌腱膜炎病例临床症状轻微,在3个月内痊愈。手腕处3处伤口的炎症在拆除经皮缝线后2天内消退。这3例患者在术后几天内就恢复了重度手部活动。