Abdullah A F, Wolber P H, Ditto E W
Department of Neurosurgery, Washington County Hospital, Hagerstown, Maryland, USA.
Neurosurgery. 1995 Nov;37(5):931-5; discussion 935-6. doi: 10.1227/00006123-199511000-00012.
The sequelae of carpal tunnel surgery were reviewed and were presumed to be associated with the linear vertical section of the transverse carpal ligament because this was the common element in the reported series. The authors adopted a modified approach, substituting a parabolic incision that left a protective flap of the ligament to cover the structures within the tunnel in the area of maximum convexity of the wrist. The results from a recent series of 100 cases were contrasted with a control series of 770 previous cases. Untoward postoperative sequelae were significantly reduced through this modified approach. The improved results, the authors conclude, were attributable to a reduction of pressure within the carpal tunnel, while avoiding the wide gaping of the tunnel space that is associated with vertical incisions, which may allow an anterior displacement of the median nerve and flexor tendons between the cut ends of the transverse carpal ligament and sometimes result in a continuous scar through the skin.
对腕管手术的后遗症进行了回顾，并推测其与腕横韧带的线性垂直部分有关，因为这是报道系列中的共同因素。作者采用了一种改良方法，采用抛物线形切口，留下韧带的保护瓣，以覆盖腕部最大凸度区域隧道内的结构。最近一组100例病例的结果与之前770例对照系列进行了对比。通过这种改良方法，术后不良后遗症显著减少。作者得出结论，改善的结果归因于腕管内压力的降低，同时避免了与垂直切口相关的隧道空间的广泛张开，垂直切口可能会使正中神经和屈肌腱在腕横韧带的切断端之间向前移位，有时会导致皮肤出现连续瘢痕。
