[1]孙贵新①,史其林,李文军,等.内镜下切断屈肌支持带远侧纤维束治疗腕管综合征[J].中国微创外科杂志,2006,06(7):494-496.
　Sun Guixin,Sh iQilin*,Li Wenjun*,et al.Endoscopic release of distal holdfast fibers of the flexor retinaculum for carpal tunnel syndrome[J].Chinese Journal of Minimally Invasive Surgery,2006,06(7):494-496.
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内镜下切断屈肌支持带远侧纤维束治疗腕管综合征()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
06
期数:
2006年7期
页码:
494-496
栏目:
出版日期:
2006-07-20

文章信息/Info

Title:
Endoscopic release of distal holdfast fibers of the flexor retinaculum for carpal tunnel syndrome　
作者:
孙贵新①; 史其林; 李文军; 郑宪友; 杨明杰; 顾玉东
复旦大学附属华山医院手外科,上海,200040
Author(s):
Sun Guixin;  Sh iQilin*;  Li Wenjun*;  et al.*
Department of Hand Surgery, Huashan Hospital of Fudan University, Shanghai 200040, China
关键词:
腕管综合征; 屈肌支持带远侧纤维束; 腕横韧带; 内镜?
Keywords:
Carpal tunnel syndrome; 　Distal holdfast fibers of the flexor retinaculum; 　Flexor retinaculum; 　Endoscope
分类号:
R658.2;R44.28
文献标志码:
A
摘要:
目的探讨内镜下腕管切开减压术(endoscopic carpal tunnel release, ECTR)中切断屈肌支持带远侧纤维束(distal holdfast fibers of the flexor retinaculum, 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(χ2=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.
Abstract:
Objective　To investigate the necessity of releasing the distal holdfast fibers of the flexor retinaculum (DHFFR) during endoscopic carpal tunnel release (ECTR).　M ethods　The Experiment Group included 16 cases. The operation was conducted under brachialplexus anesthesiawithout the use of tourniquet. A 1 cm skin incisionwasmade. TheUSE system (Universal Subcutaneous Endoscope System) was employed. Both flexor retinaculum (FR) and distalholdfast fibers of the flexor retinaculum were cut of.f Postoperative outcomeswere compared with another16 cases of flexor retinaculum release only (ControlGroup).　Results　 Follow-up evaluation was carried out at6 postoperative months. According to the Kelly’s criteria, there were 13 cases of excellent results and 3 cases of good results in theExperimentGroup, and 8 cases ofexcellent, 5 cases ofgood, and 3 cases of fair results in the ControlGroup. Significantdifferencewas obser red in flamedaⅡorⅢgrade patients between the two groups in carative effects (χ2= 6·278,P=0·043). No serious complications orpostoperative recurrence occurred.　Conclusions　Flexor retinaculum is not the only structure existing in the carpal canal to be released. More attention should be paid to complete decompression ofboth flexor retinaculum and distal holdfast fibers of the flexor retinaculum, especially in thosewho have serious symptoms.

参考文献/References:

[1]史其林,孙贵新,杨素敏,等.微创内镜下治疗腕管综合征--附69例报告.中国微创外科杂志,2001,1(4):331-333.
[2]史其林,郑宪友,孙贵新,等.Chow法内镜下治疗腕管综合征的临床经验.中国微创外科杂志,2003,3(4):297-299.
[3]Okutsu I,Hamanaka I,Ninomiya S.Achieving optimum results in endoscopic tunnel release-4373 clinical experiences.In:Ridvan E,ed.8th congress of the international federation of societies for surgery of the hand (IFSSH).Istanbul Turkey,2001.510-515.
[4]浜田良机ほか.手根管症候群の治疗成绩.日手会志,1985,2:156-159.
[5]Kelly CP,Pulisetti D,Jamieson AM.Early experience with endoscopic carpal tunnel release.J Hand Surg,1994,19(1):18-21.
[6]孙贵新,史其林,官士兵,等.腕管综合征内镜诊治新方法-改良奥津法.国外医学?骨科学分册,2002,23(1):45-47.

备注/Memo

备注/Memo:
①（上海同济大学附属东方医院创伤中心,上海,200120）
更新日期/Last Update: 2014-02-13