内窥镜辅助下改良Okutsu法治疗腕管综合征的临床疗效

Clinical efficacy of endoscopic assisted modified Okutsu method in the treatment of carpal tunnel syndrome

目的探讨内窥镜辅助下于腕管外切开腕横韧带治疗腕管综合征的临床疗效,评估内窥镜单入路对术后掌根痛及手功能感觉恢复的临床效果。方法回顾性分析自2021年6月至2023年6月徐州仁慈医院手外科24例腕管综合征患者,采用远端腕横纹处单一横切口,腕管外简易扩张,内窥镜辅助下切开腕横韧带,术后观察掌根痛以及正中神经支配区皮肤麻木恢复程度和拇指运动功能。应用顾玉东推荐的腕管综合征功能评定标准评价手功能及感觉。结果24例患者均获得随访,术后1 d麻木症状缓解,切口无感染,掌根无柱状痛。术后6个月根据腕管综合征功能评定标准优19例,良3例,可2例,优良率为91.67%。结论内窥镜辅助下改良Okutsu法是治疗腕管综合征的一种安全有效的微创手术,其疗效可靠,康复时间短,是值得推荐的治疗方法。

Objective Explore the clinical efficacy of endoscopic assisted incision of the transverse carpal ligament outside the carpal tunnel for the treatment of carpal tunnel syndrome,and evaluate the clinical effect of endoscopic single approach on postoperative palmar root pain and hand functional sensation recovery.Methods A retrospective analysis was conducted on 24 patients with carpal tunnel syndrome in Department of Hand Surgery of Xuzhou Renci Hospital from June 2021 to June 2023.A single transverse incision was made at the distal wrist crease,with simple expansion outside the carpal tunnel.The transverse ligament of the wrist was incised with endoscopic assistance,and postoperative palmar root pain,recovery of skin numbness in the median nerve innervation area,and thumb motor function were observed.The carpal tunnel syndrome assessment criteria recommended by Gu Yudong were applied to assess hand function and sensation.Results All 24 patients were followed up and their numbness symptoms improved one day after surgery.There was no infection in the incision and no columnar pain in the palm root.6 months after surgery,according to criteria of carpal tunnel syndrome,19 cases were rated as excellent,3 cases as good,and 2 cases as fair,with excellent and good rate of 91.67%.Conclusion The modified Okutsu method assisted by endoscopy is a safe and effective minimally invasive surgery for the treatment of carpal tunnel syndrome as a recommendable method,with reliable efficacy and short recovery time.