Bensimon R H, Murphy R X
Department of Surgery, Emerson Hospital, Concord, MA, USA.
Ann Plast Surg. 1996 May;36(5):462-5. doi: 10.1097/00000637-199605000-00004.
The midpalmar approach involves making a 2.5-cm incision in the palm, sparing the skin directly overlying the carpal tunnel. Through this incision, a small fiber-optically illuminated retractor is introduced, which allows direct inspection of the transverse carpal ligament and any anatomic variations of the median nerve. The transverse carpal ligament can then be safely and completely divided under direct visualization. This approach also allows inspection of the carpal tunnel for any space-occupying masses or neurolysis, if deemed necessary. By avoiding a skin incision directly over the carpal tunnel, the postoperative course is very gentle and very similar to that of an endoscopic release. Unlike the endoscopic release, this approach is versatile, easy to learn, allows complete visualization of the anatomy, and does not require expensive instrumentation.
掌中部入路是在手掌做一个2.5厘米的切口，避开直接覆盖腕管的皮肤。通过这个切口，引入一个小型光纤照明牵开器，可直接检查腕横韧带以及正中神经的任何解剖变异。然后可以在直视下安全、完整地切断腕横韧带。如有必要，该入路还可检查腕管内是否有占位性肿块或进行神经松解。通过避免在腕管上方直接做皮肤切口，术后恢复过程非常顺利，与内镜下松解术非常相似。与内镜下松解术不同的是，这种入路用途广泛，易于学习，能完整观察解剖结构，且不需要昂贵的器械。
