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[内镜下腕管松解术的技术、结果及风险]

[Technique, results and risks of endoscopic carpal tunnel release].

作者信息

Kröpfl A, Gasperschitz F, Hertz H

出版信息

Handchir Mikrochir Plast Chir. 1996 May;28(3):120-7.

PMID:8767941
Abstract

Endoscopic carpal tunnel release was performed in 168 cases of carpal tunnel syndrome using the two-portal technique described by Chow. There were 164 cases of idiopathic carpal tunnel syndrome and four cases following a wrist trauma. Sensory symptoms improved within few days in 113 patients (67%) and in 141 cases within eight weeks (84%). Nighttime pain relief was achieved immediately in 87% of the patients and in 94% within eight weeks. Grip strength increased to preoperative values within eight weeks and pinch strength reached preoperative levels within six weeks. In four cases an iatrogenic injury of the superficial palmar vascular arch occurred. In another four patients, open revisional surgery had to be performed. Three of these patients presented an incomplete release of the retinaculum flexorum and in one patient a remaining part of the palmar fascia led to further compression of the median nerve despite complete dissection of the carpal ligament.

摘要

采用Chow描述的双入路技术,对168例腕管综合征患者实施了内镜下腕管松解术。其中特发性腕管综合征164例,腕部外伤后腕管综合征4例。113例患者(67%)在数天内感觉症状改善,141例患者(84%)在8周内感觉症状改善。87%的患者夜间疼痛立即缓解,94%的患者在8周内夜间疼痛缓解。握力在8周内恢复到术前水平,捏力在6周内达到术前水平。4例发生医源性掌浅血管弓损伤。另外4例患者需行开放性翻修手术。其中3例患者屈肌支持带松解不完全,1例患者尽管腕横韧带已完全松解,但掌腱膜残留部分导致正中神经进一步受压。

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