掌腱膜挛缩症合并腕管综合征的诊断和治疗

The diagnosis and treatment of Dupuytren＇s contracture combined with carpal tunnel syndrome

目的探讨掌腱膜挛缩症与腕管综合征的相关性及一次完成两种手术的治疗效果。方法2003年3月至2011年8月，对8例掌腱膜挛缩症合并腕管综合征的患者，其中右手5例、左手3例，设计手掌部“M”形切口，或同时加手指的“Y”形切口，同时切除部分掌腱膜，行屈肌支持带切开、正中神经松解术。结果术后全部伤口均I期愈合，无皮瓣边缘坏死及血肿形成，术后拇、示、中指麻木逐渐减轻，术后3个月手指麻木全部消失。术后随访时间为6个月至2年，掌腱膜挛缩元复发。结论掌腱膜挛缩症与腕管综合征两种疾病的诱发因素较多地发生在同一个体时，两种疾病同时并发的几率明显增加，可通过一次手术完成。

Objective To investigate the correlation of Dupuytren＇ s contracture and carpal tunnel syndrome and evaluate the clinical outcomes of treating both diseases in one surgery. Methods From March 2003 to August 2011, 8 cases of Dupuytren＇s contracture combined with carpal tunnel syndrome were surgically treated. Through an M-shaped palm incision and a Y-shaped incision extended to the finger, the palmar aponeurosis was partially removed and the flexor retinaculum was cut open to release the median nerve at the same time. Results Primary wound healing was achieved in all of the eight cases. There were no flap edge necrosis and hematoma formation. Numbness of the thumb, index finger and middle finger gradually reduced postoperatively. The numbness disappeared after 3 months. All patients were follow-up for 6 months to 2 years with no recurrence. Conclusion When more predisposing factors of both diseases occur in one patient, the probability of the occurrence of both Dupuytren＇ s eontracture and carpal tunnel syndrome in one patient also increases significantly. The two diseases can be treated in one surgery.