AIM To compared outcomes between the hypothenar fat pad flap(HTFPF) and conventional open carpal tunnel release(COR) in primary carpal tunnel syndrome(CTS). METHODS Forty-five patients(49 hands) were enrolled into the...AIM To compared outcomes between the hypothenar fat pad flap(HTFPF) and conventional open carpal tunnel release(COR) in primary carpal tunnel syndrome(CTS). METHODS Forty-five patients(49 hands) were enrolled into the study from January 2014 to March 2016, 8 patients were excluded. Randomization was conducted in 37 patients(41 hands) by computer generated(Block of four randomization) into COR and HTFPF group. Nerve conduction study(NCS) included distal sensory latency(DSL), distal motor latency(DML), sensory amplitude (S-amp), motor amplitude(M-amp) and sensory nerve conduction velocity(SCV) were examined at 6 and 12 wk after CTR. Levine score, grip and pinch strength, pain [visual analog scale(VAS)], 2-point discrimination(2-PD), Semmes-Weinstein monofilament test(SWM), Phalen test and Tinel's sign were evaluated in order to compare treatment outcomes.RESULTS The COR group, 19 patients(20 hands) mean age 50.4 years. The HTFPF group, 20 patients(21 hands) mean age 53.3 years. Finally 33 patients(36 hands) were analysed, 5 patients were loss follow-up, 17 hands in COR and 19 hands in HTFPF group. NCS revealed significant difference of DSL in HTFPF group at 6 wk(P < 0.05) compared with the COR group. S-amp was significant improved postoperatively in both groups(P < 0.05) but not significant difference between two groups. No significant difference of DML, M-amp and SCV postoperatively in both groups and between two groups. Levine score, pain(VAS), grip and pinch strength, 2-PD, SWM, Phalen test and Tinel's sign were improved postoperatively in both groups, but there was no significant difference between two groups.CONCLUSION There is no advantage outcome in primary CTS for having additional HTFPF procedure in CTR. COR is still the standard treatment. Nevertheless, improvement of DSL and S-amp could be observed at 6 wk postoperatively.展开更多
目的应用带蒂筋膜脂肪瓣覆盖修复的肌腱,探讨一种既能够促进愈合又能防止粘连的肌腱修复方法。方法选取SD大鼠18只,每只大鼠的右后肢跟腱为实验组(FW),左后肢为对照组(TS)。FW组以筋膜脂肪瓣翻转蒂部后包裹覆盖修复的肌腱;TS组仅对肌腱...目的应用带蒂筋膜脂肪瓣覆盖修复的肌腱,探讨一种既能够促进愈合又能防止粘连的肌腱修复方法。方法选取SD大鼠18只,每只大鼠的右后肢跟腱为实验组(FW),左后肢为对照组(TS)。FW组以筋膜脂肪瓣翻转蒂部后包裹覆盖修复的肌腱;TS组仅对肌腱做显微缝合修复。分别在术后2、4、8周采取标本,做大体观察、组织学切片检查和功能恢复实验,并进行评估、分级和统计(paired/matchedt-test和wilcoxon rank sum test)。结果大体和组织学观察,2、4、8周FW组肌腱愈合更优,而粘连度却小于TS组(P<0.05);功能恢复实验,FW组关节的活动度大于TS组,平均73.9%比62.5%。结论肌腱缝合术后,利用带蒂筋膜脂肪瓣包裹覆盖修复位点,有促进肌腱愈合,防止粘连的作用。展开更多
文摘AIM To compared outcomes between the hypothenar fat pad flap(HTFPF) and conventional open carpal tunnel release(COR) in primary carpal tunnel syndrome(CTS). METHODS Forty-five patients(49 hands) were enrolled into the study from January 2014 to March 2016, 8 patients were excluded. Randomization was conducted in 37 patients(41 hands) by computer generated(Block of four randomization) into COR and HTFPF group. Nerve conduction study(NCS) included distal sensory latency(DSL), distal motor latency(DML), sensory amplitude (S-amp), motor amplitude(M-amp) and sensory nerve conduction velocity(SCV) were examined at 6 and 12 wk after CTR. Levine score, grip and pinch strength, pain [visual analog scale(VAS)], 2-point discrimination(2-PD), Semmes-Weinstein monofilament test(SWM), Phalen test and Tinel's sign were evaluated in order to compare treatment outcomes.RESULTS The COR group, 19 patients(20 hands) mean age 50.4 years. The HTFPF group, 20 patients(21 hands) mean age 53.3 years. Finally 33 patients(36 hands) were analysed, 5 patients were loss follow-up, 17 hands in COR and 19 hands in HTFPF group. NCS revealed significant difference of DSL in HTFPF group at 6 wk(P < 0.05) compared with the COR group. S-amp was significant improved postoperatively in both groups(P < 0.05) but not significant difference between two groups. No significant difference of DML, M-amp and SCV postoperatively in both groups and between two groups. Levine score, pain(VAS), grip and pinch strength, 2-PD, SWM, Phalen test and Tinel's sign were improved postoperatively in both groups, but there was no significant difference between two groups.CONCLUSION There is no advantage outcome in primary CTS for having additional HTFPF procedure in CTR. COR is still the standard treatment. Nevertheless, improvement of DSL and S-amp could be observed at 6 wk postoperatively.
文摘目的应用带蒂筋膜脂肪瓣覆盖修复的肌腱,探讨一种既能够促进愈合又能防止粘连的肌腱修复方法。方法选取SD大鼠18只,每只大鼠的右后肢跟腱为实验组(FW),左后肢为对照组(TS)。FW组以筋膜脂肪瓣翻转蒂部后包裹覆盖修复的肌腱;TS组仅对肌腱做显微缝合修复。分别在术后2、4、8周采取标本,做大体观察、组织学切片检查和功能恢复实验,并进行评估、分级和统计(paired/matchedt-test和wilcoxon rank sum test)。结果大体和组织学观察,2、4、8周FW组肌腱愈合更优,而粘连度却小于TS组(P<0.05);功能恢复实验,FW组关节的活动度大于TS组,平均73.9%比62.5%。结论肌腱缝合术后,利用带蒂筋膜脂肪瓣包裹覆盖修复位点,有促进肌腱愈合,防止粘连的作用。
