摘要
目的探讨内镜下腕管切开减压术(endoscop ic carpal tunnel release,ECTR)中切断屈肌支持带远侧纤维束(d istal holdfast fibers of the flexor retinacu lum,DHFFR)的必要性。方法观察组16例,臂丛神经阻滞麻醉,不使用止血带,皮肤1 cm切口,内镜下应用USE系列切断腕管横韧带和DHFFR,与对照组16例单纯切断腕管横韧带进行疗效比较。结果术后6个月功能随访,按照Kelly疗效评定标准,观察组优13例,良3例;对照组优8例,良5例,可3例,2组浜田Ⅱ、Ⅲ级疗效差异有显著性(2χ=6.278,P=0.043)。2组均无严重并发症及术后复发。结论对浜田Ⅱ、Ⅲ级腕管综合征者术中注意腕横韧带切断不是唯一的目标,同时切断DHFFR才能彻底减压。
Objective To investigate the necessity of releasing the distal holdfast fibers of the flexor retinaeulum （DHFFR） during endoscopic carpal tunnel release （ECTR）. Methods The Experiment Group included 16 cases. The operation was conducted under braehial plexus anesthesia without the use of tourniquet. A 1 em skin incision was made. The USE system （ Universal Subcutaneous Endoscope System） was employed. Both flexor retinaeulum （FR） and distal holdfast fibers of the flexor retinaeulum were cut off. Postoperative outcomes were compared with another 16 cases of flexor retinaeulum release only （Control Group）. Results Follow- up evaluation was carried out at 6 postoperative months. According to the Kelly＇s criteria, there were 13 cases of excellent results and 3 cases of good results in the Experiment Group, and 8 cases of excellent, 5 cases of good, and 3 cases of fair results in the Control Group. Significant difference was obser red in flameda Ⅱ or Ⅲ grade patients between the two groups in earative effects （X^2 = 6. 278, P = 0. 043 ）. No serious complications or postoperative recurrence occurred. Conclusions Flexor retinaeulum is not the only structure existing in the carpal canal to be released. More attention should be paid to complete decompression of both flexor retinaeulum and distal holdfast fibers of the flexor retinaeulum, especially in those who have serious symptoms.
出处
《中国微创外科杂志》
CSCD
2006年第7期494-496,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
腕管综合征
屈肌支持带远侧纤维束
腕横韧带
内镜
Carpal tunnel syndrome
Distal holdfast fibers of the flexor retinaeulum
Flexor retinaeulum
Endoscope
