远侧腕横纹处单一小切口与传统切口治疗滨田Ⅱ型腕管综合征疗效对比  

Clinical comparison analysis of traditional open incision and small incision techniques of distal transverse wrist crease for Hamada typeⅡcarpal tunnel syndrome

作　　者：申浩博 丁文强 刘宏君 王天亮 顾加祥 SHEN Haobo;DING Wenqiang;LIU Hongjun(Dalia Medical University,Dalian,Liaoning,116011,China)

机构地区：[1]大连医科大学,辽宁大连116011 [2]扬州大学临床医学院手足显微外科,江苏扬州225001

出　　处：《实用手外科杂志》2024年第3期320-322,352,共4页Journal of Practical Hand Surgery

摘　　要：目的 探讨腕横纹处小切口和传统切口治疗滨田Ⅱ型腕管综合征的临床疗效。方法 2008年9月-2020年9月,分别采用远侧腕横纹处单一小切口和传统切口手术治疗滨田Ⅱ型腕管综合征84例,术后行腕管综合征功能评定标准评分及并发症分析。结果 术后随访12~24个月(平均13个月),传统切口手术时间10~15 min,平均12.3 min;小切口手术时间10~20 min,平均13.6 min。按顾玉东评分标准评定优良率,小切口组为91%,传统切口组为89%。术中发生血管神经损伤,小切口组8例,传统切口组3例。术后两组均无感染发生。末次随访发生柱状痛,小切口组5例,传统切口7例。术后复发,小切口组3例,传统切口组5例。术后瘢痕增生,小切口组0例,传统切口组2例。结论 小切口和传统切口治疗腕管综合征均取得较好的效果。术后随访1年以上柱状痛、复发率及功能评分差异无统计学意义。Objective To compare the clinical outcomes of mini distal transverse wrist crease incision release and classical open carpal tunnel release for treating Hamata typeⅡcarpal tunnel syndrome.Methods Between September 2009 and September 2020,86 patients with 106 wrists of Hamata typeⅡcarpal tunnel syndrome were treated surgically.Functional outcomes and complications were assessed.Results The verage follow-up was 13 months(range,12-24 months).Mean operation time was 12.3 minutes in mini incision group and 13.6 minutes in traditional incision group.According to Gu Yudong's scoring standard,the excellent and good rate was 91%in mini incision group versus 89%in traditional incision group.Vascular and nerve injury occurred in 8 cases in the small incision group and 3 cases in the traditional incision group.No postoperative infection occurred.At the last follow-up,there were 5 patients with pillar pain in the small incision group and 7 patients in the traditional incision group,Recurrence occurred in 3 patients in small incision group and 5 patients in traditional incision group,2 scar hyperplasia occurred in traditional incision group and 0 occurred in small incision group.Conclusion Both mini transverse incision release and traditional open incision can achieved satisfied results for treating Hamata typeⅡcarpal tunnel syndrome.There was no significant difference in columnar pain,recurrence rate and functional score over 1 year follow-up.

关 键 词：腕管综合征 腕管松解 柱状痛 复发 随访 

分 类 号：R688[医药卫生—骨科学]