Plancher K D, Idler R S, Lourie G M, Strickland J W
Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA.
Hand Clin. 1996 May;12(2):337-49.
Open decompression of the median nerve generally is so effective that little is mentioned of the surgical treatment options for recalcitrant or unrelieved carpal tunnel syndrome. The hypothenar fat pad flap has been shown to be a reliable local source of well-vascularized adipose tissue that can be used for coverage of the median nerve during re-exploration of recurrent or persistent idiopathic carpal tunnel syndrome. The hypothenar fat pad flap is a technically simple procedure that allows the fat pad to be mobilized easily and placed across the palm as a barrier between the nerve and the radial leaf of the transverse carpal ligament, effectively preventing median nerve readherence. This flap hopefully will improve the tissue environment for the median nerve, permitting it to have normal excursion during wrist motion. Our results to date have been better than previously described for other techniques. We believe the hypothenar fat pad flap should be considered in the hand surgeon's armamentarium for recalcitrant idiopathic carpal tunnel syndrome.
正中神经的开放减压术通常非常有效，以至于对于顽固性或未缓解的腕管综合征的手术治疗选择很少被提及。小鱼际脂肪垫瓣已被证明是一种可靠的局部血管丰富的脂肪组织来源，可用于复发性或持续性特发性腕管综合征再次探查时覆盖正中神经。小鱼际脂肪垫瓣是一种技术上简单的手术，能轻松移动脂肪垫并将其置于手掌上作为神经与腕横韧带桡侧叶之间的屏障，有效防止正中神经再次粘连。该皮瓣有望改善正中神经的组织环境，使其在腕关节活动时能正常移动。我们目前的结果比之前描述的其他技术更好。我们认为，对于顽固性特发性腕管综合征，手外科医生的手术方法中应考虑采用小鱼际脂肪垫瓣。
