Ultrasound-guided minimally invasive thread release of carpal tunnel: a cadaveric study.

IF 9.7 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Radiologia Medica Pub Date : 2025-01-21 DOI:10.1007/s11547-025-01952-w
Suren Jengojan, Philipp Sorgo, Alessio Piacentini, Johannes Streicher, Domenico Albano, Gregor Kasprian, Veith Moser, Gerd Bodner
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Abstract

Purpose: Thread release of the carpal tunnel is the most recent of several minimally invasive ultrasound-guided carpal tunnel release techniques. The purpose of this article is to provide a step-by-step guide for minimally invasive, ultrasound-guided thread release of the carpal tunnel focused on transecting the transverse carpal ligament with minimal damage to the palmar aponeurosis on anatomical specimens.

Methods: Fifteen ultrasound-guided carpal tunnel thread releases were performed on the wrists of soft-embalmed anatomical specimens, which were dissected immediately after the intervention. The procedures were performed by two musculoskeletal radiologists with 25 and 8 years of experience, respectively, in interventional radiology. Ultrasound visibility, completeness of transection, and damage to surrounding structures were evaluated on a score from 1 to 3.

Results: We achieved a complete transection of the transverse carpal ligament in 11 of 15 interventions (73%) and an incomplete transection in the remaining four (27%). No neural or vascular structures were harmed. In two cases (13%), there was irrelevant damage to flexor tendons. The ultrasound visibility was rough in five specimens (33.3%), moderate in five (33.3%), and optimal in five (33.3%). Essential structures were delineated in all cases.

Conclusion: Thread release of the carpal tunnel leads to only minimal damage to skin, as well as structures within the carpal tunnel and the palmar aponeurosis, promising a low amount of postinterventional complications.

Relevance statement: Our study showed that minimally invasive ultrasound-guided thread release of the carpal tunnel is a feasible approach in the anatomical model. The results may provide a basis for further research and refinement of this technique.

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超声引导下微创腕管松解术:一项尸体研究。
目的:腕管螺纹松解术是超声引导下最新的微创腕管松解术。本文的目的是提供一个循序渐进的微创指导,超声引导下的腕管松解术重点是横切腕横韧带,在解剖标本上对掌腱膜的损伤最小。方法:对15例软防腐解剖标本进行超声引导下腕管松解术,干预后立即剥离。手术由两名分别具有25年和8年介入放射学经验的肌肉骨骼放射科医生执行。超声可视性、横断完整性和对周围结构的损伤程度评分为1 - 3分。结果:15例干预中有11例(73%)实现了腕横韧带的完全横断,其余4例(27%)实现了腕横韧带的不完全横断。未见神经或血管结构损伤。在两例(13%)中,屈肌腱有不相关的损伤。超声可见性为粗糙5例(33.3%),中等5例(33.3%),最佳5例(33.3%)。所有病例的基本结构都被描绘出来。结论:腕管松解术对皮肤、腕管内结构和掌腱膜的损伤很小,介入后并发症发生率低。相关声明:我们的研究表明微创超声引导下的腕管松解术在解剖模型中是一种可行的方法。研究结果可为该技术的进一步研究和完善提供基础。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Radiologia Medica
Radiologia Medica 医学-核医学
CiteScore
14.10
自引率
7.90%
发文量
133
审稿时长
4-8 weeks
期刊介绍: Felice Perussia founded La radiologia medica in 1914. It is a peer-reviewed journal and serves as the official journal of the Italian Society of Medical and Interventional Radiology (SIRM). The primary purpose of the journal is to disseminate information related to Radiology, especially advancements in diagnostic imaging and related disciplines. La radiologia medica welcomes original research on both fundamental and clinical aspects of modern radiology, with a particular focus on diagnostic and interventional imaging techniques. It also covers topics such as radiotherapy, nuclear medicine, radiobiology, health physics, and artificial intelligence in the context of clinical implications. The journal includes various types of contributions such as original articles, review articles, editorials, short reports, and letters to the editor. With an esteemed Editorial Board and a selection of insightful reports, the journal is an indispensable resource for radiologists and professionals in related fields. Ultimately, La radiologia medica aims to serve as a platform for international collaboration and knowledge sharing within the radiological community.
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