Okutsu I, Hamanaka I, Tanabe T, Takatori Y, Ninomiya S
Department Chief of Orthopaedic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan.
Am J Orthop (Belle Mead NJ). 1996 May;25(5):365-8.
We made a model of the endoscopic decompression of the carpal canal in clinical cases. The model entailed the release of the transverse carpal ligament, ie, the flexor retinaculum, first; then the transverse fibers: deep layer of the midpalmar fascia or distal portion of the flexor retinaculum; and, finally, release of the forearm fascia. Carpal canal pressure was measured using the continuous infusion technique, and the carpal canal was observed endoscopically at each step. Carpal canal pressure data were analyzed by using the Wilcoxon matched pairs signed-rank test. When the transverse carpal ligament and the transverse fibers were divided, carpal canal pressure was significantly statistically lower than that with release of the transverse carpal ligament alone. We conclude that release of both the transverse carpal ligament and the transverse fibers are essential for complete decompression of the carpal canal in endoscopic surgery.
我们建立了一个临床病例中腕管内镜减压的模型。该模型首先需要松解腕横韧带，即屈肌支持带；然后松解横行纤维：掌中间隙深层筋膜或屈肌支持带的远端部分；最后，松解前臂筋膜。使用连续灌注技术测量腕管压力，并在每个步骤通过内镜观察腕管。使用Wilcoxon配对符号秩检验分析腕管压力数据。当腕横韧带和横行纤维被切断时，腕管压力在统计学上显著低于仅松解腕横韧带时。我们得出结论，在内镜手术中，松解腕横韧带和横行纤维对于腕管的完全减压至关重要。
