手掌侧单孔入路微创治疗腕管综合征的解剖学研究

发布时间：2018-07-23 21:10

【摘要】：目的报道手掌侧单孔入路微创治疗腕管综合征的解剖入路及手术方法,为手掌侧入路微创治疗腕管综合征手术提供解剖学基础。方法选取16例新鲜成人上肢标本,解剖观测腕管及手掌的相关解剖结构。选取6例新鲜成人上肢标本进行模拟手术,镜视下切开屈肌支持带并进行神经外膜松解。结果手术入路点为拇指呈最大外展位,沿掌指关节尺侧取一平行线,与中、环指间的长轴线交叉点处向尺侧1cm处,操作层面为浅筋膜层与掌腱膜间的腔隙。结论手掌侧单孔入路微创治疗腕管综合征是安全可行的,在镜视下可彻底切开屈肌支持带并进行神经外膜松解,有利于术者进行操作及减轻术中损伤。
[Abstract]:Objective to report the anatomical approach and surgical methods of minimally invasive treatment of carpal tunnel syndrome by palmar side single hole approach, and to provide anatomical basis for minimally invasive treatment of carpal tunnel syndrome by palmar lateral approach. Methods 16 fresh adult upper limb specimens were dissected and the related anatomical structures of carpal tunnel and palm were observed. Six fresh adult upper limb specimens were selected for simulated operation. The flexor retinaculum was cut under microscope and the epineurial release was performed. Results the point of operation was the largest exposition of the thumb. A parallel line was taken along the ulnar side of the metacarpophalangeal joint. The long axis crossing point between the middle and middle fingers was directed to the ulnar 1cm, and the operating plane was the lacuna between the superficial fascia and the palmar aponeurosis. Conclusion it is safe and feasible to treat carpal tunnel syndrome with minimally invasive approach through one hole in the palmar side. The flexor spurs can be thoroughly cut and the epineurial release can be performed under the microscope, which is helpful to the operation of the operation and the reduction of injury during the operation.
【作者单位】：深圳市人民医院(暨南大学第二临床医学院);
【基金】：深圳市科研立项(201202132) 深圳市科研项目(JCYJ 20140416122811970)
【分类号】：R688;R322

【共引文献】