经腕横纹小切口治疗腕管综合征的早期疗效

Early efficacy of carpal tunnel release by small incision at transverse wrist crease

目的探讨经腕横纹小切口治疗腕管综合征的早期疗效。方法回顾分析2017年3—11月北京积水潭医院手外科经腕横纹小切口治疗的18例(20侧)腕管综合征患者的病历资料。其中男8例,女10例;2例双侧发病,16例单侧发病。于腕中横纹处掌长肌腱尺侧做一2 cm的横行切口,松解前臂屈肌筋膜,并在头戴式放大镜下切开腕横韧带。结果所有病例均随访3个月以上,16例患者(18侧)感觉恢复正常,其中包括五个手指均有麻木的患者;另外2例患者仍感觉麻木,但有所减轻;术前大鱼肌中度萎缩的8例患者,肌萎缩程度明显改善,拇指对掌功能已恢复正常,捏力、握力较术前明显改善。结论经腕横纹小切口直视下行腕管松解术是一种有效微创的方法。

Objective To investigate the early efficacy of carpal tunnel release by small incision at transverse wrist crease.Methods A total of 20 hands of 18 patients with carpal tunnel syndrome were operated on,included 8 males and 10 females,in Beijing Jishuitan Hospital between March 2017 and November 2017.Two patients were bilateral onset and 16 patients were unilateral onset.An 2 cm incision was made at the transverse wrist crease on the ulnar side of the palmaris longus tendon.The antebrachial fascia and proximal margin of the transverse carpal ligament was visualized and were cut subcutaneously under direct vision with a head-mounted magnifying glass.Results All patients were followed up more than 3 months,the symptoms of 18 fingers recovered in 16 cases which included 5 cases with numb fingers,and 2 cases still left the numbness but reduced after operation.The preoperative thenar muscle atrophy were greatly improved in 8 cases with recovery of normal opponents function of the thumb.Conclusion The small incision at transverse wrist crease is efficient and safe and a minimally invasive surgical procedure in the treatment of the carpal tunnel syndrome.