中国临床解剖学杂志 ›› 2015, Vol. 33 ›› Issue (1): 12-16.doi: 10.13418/j.issn.1001-165x.2015

• 应用解剖 • 上一篇    下一篇

手掌侧单孔入路微创治疗腕管综合征的解剖学研究

魏瑞鸿,   庄永青,   叶凤清,   姜浩力,   熊洪涛,   方锡池,    张轩   

  1. 深圳市人民医院(暨南大学第二临床医学院), 深圳  518020
  • 收稿日期:2014-10-11 出版日期:2015-01-25 发布日期:2015-02-12
  • 通讯作者: 庄永青,教授,主任医师,E-mail: zhuangyq 2002@hotmail.com E-mail:weicsly@163.com
  • 作者简介:魏瑞鸿(1986-),男,广东人,硕士,医师,主要研究方向:手显微外科,Tel:15019294025
  • 基金资助:

    深圳市科研立项(201202132); 深圳市科研项目(JCYJ 20140416122811970)

Anatomic study of the volar single-aperture approach of endoscopic carpal tunnel release

WEI Rui-hong,   ZHUANG Yong-qing,  YE Feng-qing,  JIANG Hao-li,   XIONG Hong-tao,   FANG Xi-chi,ZHANG Xuan   

  1. Shenzhen People’s Hospital(The Second Clinical College,Jinan University), Shenzhen 518020, China
  • Received:2014-10-11 Online:2015-01-25 Published:2015-02-12

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。

关键词: 手掌侧入路, 微创治疗, 腕管综合征, 解剖学研究

Abstract:

Objective   To report the palmar approach and surgical method for the view to provide anatomical data for the volar single-aperture approach of endoscopic carpal tunnel release(ECTR).  Methods 16 specimens of fresh adult upper limb were used to observe and measure the anatomical structures in the carpal tunnel and palm. 6 specimens of fresh adult upper limb were used randomly to simulate the operation that divided the flexor retinaculum and released the median nerve of ECTR by one-point technique in palm. Results   The best entrance point in palm of ECTR: Draw a parallel line along the thumb in the maximal abduction position to the ulnar side, and draw a axis between the middle finger and the ring finger; Mark the intersection of the lines, and then take an incision in the ulnar aspect about 1cm away from the intersection. Surgical plane was the lacunar space between the superficial fascia and palmar aponeursis.   Conclusion   Our study confirms that ECTR by one-point technique in palm is safe and feasible. It’s practical for surgeons to adopt the surgical approach of  ECTR and avoid damage  during severance offlexor retinaculum and relief of the median nerve under endoscope.

Key words: The entrance point in palm, Minimally invasive treatment, Carpal tunnel syndrome, Anatomical studies

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