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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。
Objective To report the anatomical approach and operation method of minimally invasive percutaneous single-hole approach for the treatment of carpal tunnel syndrome and to provide anatomic basis for the minimally invasive treatment of carpal tunnel syndrome by palmar approach. Methods Sixteen cases of fresh adult upper limbs were selected for anatomical observation of the anatomy of the carpal tunnel and palm. Six fresh adult upper limbs were selected for simulated surgery, and the flexor retinaculum was dissected under microscope and the epineurium was released. Results The surgical approach point was the maximum abduction position of the thumb, taking a parallel line along the ulnar metacarpophalangeal joint side and 1 cm to the ulnar side at the intersection of the long axis of the middle and ring fingers. The operating level was superficial fascia and palms Aponeurosis between the lacuna. Conclusion The minimally invasive treatment of carpal tunnel syndrome by single-hole palmar approach is safe and feasible. The supportive zone of the flexor digitorum can be cut completely under the microscope and the epineurium is released, which is good for the surgeon to operate and reduce the intraoperative injury .