Rowland E B, Kleinert J M
Christine M. Kleinert Institute for Hand and Micro Surgery, Louisville, Kentucky 40202.
J Bone Joint Surg Am. 1994 Feb;76(2):266-8. doi: 10.2106/00004623-199402000-00015.
Endoscopic carpal-tunnel releases were performed, with use of the two-portal technique described by Chow, on twenty-four fresh or fresh-frozen wrist specimens from cadavera. Twelve surgeons were taught the technique in the cadaver model by an experienced colleague. Nine surgeons performed one endoscopic carpal-tunnel release; three performed three or more. Incomplete release of the transverse carpal ligament was noted in nine specimens (38 per cent). The percentage of incomplete releases was the same for both the surgeons who performed one endoscopic carpal-tunnel release and those who performed three or more. Complications occurred in four specimens (17 per cent) and included lacerations of an ulnar artery and a median nerve, partial laceration of a flexor tendon, and a fracture of the hook of the hamate. The observed complications and incomplete releases of the transverse carpal ligament in this training model emphasize the risks that may occur when a surgeon is first learning this procedure.
采用Chow描述的双入路技术，对24个来自尸体的新鲜或新鲜冷冻的腕关节标本进行了内镜下腕管松解术。12名外科医生由一位经验丰富的同事在尸体模型上教授该技术。9名外科医生进行了1次内镜下腕管松解术；3名外科医生进行了3次或更多次。9个标本（38%）发现腕横韧带松解不完全。进行1次内镜下腕管松解术的外科医生和进行3次或更多次的外科医生，其不完全松解的比例相同。4个标本（17%）出现了并发症，包括尺动脉和正中神经撕裂、屈肌腱部分撕裂以及钩骨钩骨折。在这个训练模型中观察到的并发症和腕横韧带松解不完全的情况，强调了外科医生首次学习该手术时可能出现的风险。
