Nakao E, Short W H, Werner F W, Fortino M D, Palmer A K
Department of Orthopedic Surgery, State University of New York Health Science Center, Syracuse, USA.
J Hand Surg Am. 1998 Jan;23(1):43-7. doi: 10.1016/S0363-5023(98)80087-7.
The purpose of this experiment was to determine the amount of tissue that must be sectioned to adequately decompress the median nerve during an endoscopic carpal tunnel release procedure. In 6 fresh cadaver forearms, 2 balloons were inserted into the carpal tunnel. The first balloon was filled with saline solution to cause an initial carpal intracanal pressure of 50 mmHg. Pressure measurements were recorded, using the second balloon, at various increments of the flexor retinaculum division at 3 wrist positions (neutral, 35 degrees ; flexion, 35 degrees extension). At all increments of sectioning, carpal tunnel pressures in the neutral wrist position were consistently lowest and the values in 35 degrees extension were greatest. At each wrist flexion/extension angle, the pressure statistically decreased during incremental division of the flexor retinaculum. Incomplete release of the transverse carpal ligament resulted in incomplete decompression in the canal. Sectioning the overlying aponeurosis caused a further significant decrease in intracanal pressure.
本实验的目的是确定在内镜下腕管松解手术过程中，为充分减压正中神经所需切开的组织量。在6只新鲜尸体前臂中，将2个球囊插入腕管。第一个球囊注入盐溶液，使腕管内初始压力达到50 mmHg。使用第二个球囊，在3个腕部位置（中立位、35度屈曲、35度伸展）的屈肌支持带不同切开程度下记录压力测量值。在所有切开程度下，中立位腕部的腕管压力始终最低，伸展35度时的压力值最高。在每个腕部屈伸角度，随着屈肌支持带的逐步切开，压力在统计学上均降低。腕横韧带不完全松解导致管内减压不完全。切开覆盖的腱膜导致管内压力进一步显著降低。
