Schwartz J T, Waters P M, Simmons B P
Brigham and Women's Hospital, Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
Arthroscopy. 1993;9(2):209-13. doi: 10.1016/s0749-8063(05)80376-7.
Endoscopic carpal tunnel release was performed on 13 fresh-frozen cadavers using the Agee 3-M "Inside Job" Endoscopic Carpal Tunnel Release System, by a surgeon specifically trained in the technique and with a large clinical experience. Independent dissections showed no inadvertent lacerations to nerves, vessels, or tendons. The superficial palmar arch, the communicating branch between the ulnar and median nerves at the palm, and the common digital nerves to the third and fourth web spaces were the structures most at risk. Measurements of the distances between external landmarks were not helpful in accurately predicting the depth of blade insertion. In five of 13 cases there was complete release of the transverse carpal ligament. In four of the remaining eight cases fine fibers of the transverse carpal ligament or fascia connecting the thenar and hypothenar muscles were left over. In the other four cases there was an incomplete release of the transverse carpal ligament. The palmar fascia and more volar structures were preserved in the majority of cases.
使用阿吉3-M“内部作业”腕管内镜松解系统，由一位经过该技术专门培训且具有丰富临床经验的外科医生，对13具新鲜冷冻尸体进行了腕管内镜松解术。独立解剖显示，未出现对神经、血管或肌腱的意外撕裂伤。掌浅弓、手掌处尺神经与正中神经之间的交通支以及至第三和第四指蹼间隙的指总神经是最易受损的结构。测量外部标志之间的距离无助于准确预测刀片插入的深度。13例中有5例实现了腕横韧带的完全松解。其余8例中有4例残留了腕横韧带或连接鱼际肌和小鱼际肌的筋膜的细纤维。另外4例存在腕横韧带松解不完全的情况。大多数病例中保留了掌腱膜和更掌侧的结构。
