[Endoscopic release of the carpal tunnel using the Agee technique modified by Neumann].

IF 1 4区医学 Q3 ORTHOPEDICS Operative Orthopadie Und Traumatologie Pub Date : 2023-06-01 DOI:10.1007/s00064-023-00804-y

A Neumann, T Kponton

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引用次数: 0

Abstract

Objective: Decompression of the median nerve by complete endoscopic release of the transverse carpal ligament (TCL) and the distal antebrachial fascia. Minimization of surgical trauma results in decreased postoperative morbidity and earlier return to work and daily activities.

Indications: Symptomatic carpal tunnel syndrome.

Contraindications: Revision surgery after open or endoscopic procedure, rheumatic diseases.

Surgical technique: Small transverse incision at the ulnar border of the palmaris longus tendon, and proximal to the distal wrist flexion crease. Exposure and incision of the antebrachial fascia, dilatation of the carpal tunnel and dissection of synovial tissue from the undersurface of the TCL. With the wrist in extension, the endoscopic blade assembly with integrated camera is inserted into the canal. Exposure of TCL and short incision in the middle portion. Gradually, dissection of the distal portion of the TCL then completion by retraction of the blade distally to proximally.

Postoperative management: Slightly compressive dressing, selfcare on day 1 after procedure.

Results: More than 25 years of experience, more than 8000 treated patients, and 3 documented cases with intraoperative lesions of the median nerve requiring revision. High acceptance and patient satisfaction in AQS1 patient-reported surveillance.

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[内窥镜下使用Neumann改良的Agee技术解除腕管]。

目的:内窥镜下完全松解腕横韧带及远端肱前筋膜减压正中神经。手术创伤的最小化减少了术后发病率和早期恢复工作和日常活动。适应症:症状性腕管综合征。禁忌症:开放或内镜手术后的翻修手术，风湿病。手术技术:在掌长肌腱尺侧缘，腕屈曲纹远端近端处做小的横向切口。显露和切开肱前筋膜，扩张腕管，从TCL下表面剥离滑膜组织。腕关节伸展时，将带集成摄像头的内窥镜刀片组件插入根管。TCL暴露及中段短切口。逐渐剥离TCL的远端部分，然后通过将刀片从远端向近端缩回来完成。术后处理:轻度压缩敷料，术后第1天自我护理。结果:超过25年的经验，超过8000例治疗患者，3例记录的术中正中神经病变需要翻修。AQS1患者报告监测接受度高，患者满意度高。

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

Operative Orthopadie Und Traumatologie ORTHOPEDICS-

CiteScore

2.10

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Orthopedics and Traumatology is directed toward all orthopedic surgeons, trauma-tologists, hand surgeons, specialists in sports injuries, orthopedics and rheumatology as well as gene-al surgeons who require access to reliable information on current operative methods to ensure the quality of patient advice, preoperative planning, and postoperative care. The journal presents established and new operative procedures in uniformly structured and extensively illustrated contributions. All aspects are presented step-by-step from indications, contraindications, patient education, and preparation of the operation right through to postoperative care. The advantages and disadvantages, possible complications, deficiencies and risks of the methods as well as significant results with their evaluation criteria are discussed. To allow the reader to assess the outcome, results are detailed and based on internationally recognized scoring systems. Orthopedics and Traumatology facilitates effective advancement and further education for all those active in both special and conservative fields of orthopedics, traumatology, and general surgery, offers sup-port for therapeutic decision-making, and provides – more than 30 years after its first publication – constantly expanding and up-to-date teaching on operative techniques.