| Objective Carpal Tunnel Syndrome(CTS)is a common disease in hand surgery,and this disease is mainly caused by the compression of the Median nerve(MN).At present,the main method for the thorough treatment of CTS is carpal tunnel lysis,and the procedures for lysis are different.In this experiment,the modified Paine transverse carpal ligament knife invented in 1955 was modified to analyze the postoperative efficacy of the modified Paine transverse carpal ligament knife to treat CTS patients.The relationship between small invasive incisions and traditional surgical incisions for CTS provides theoretical and data support for clinical determination of the ideal minimally invasive small incision carpal tunnel lysis.Methods A total of 100 CTS patients(21 males,79 females,and other diseases have been excluded)in the Hand-foot Microsurgery Center of the Second Affiliated Hospital of Inner Mongolia Medical University were collected and divided into two groups;(1)Experimental group: using a modified Paine wrist beam 50 patients were treated with ligament knife surgery;(2)Control group: 50 patients were treated with traditional surgical incisions;10cadaveric hand and forearm specimens were selected from the Human Anatomy Laboratory of Inner Mongolia Medical University(wrist skin is intact,all without wrist joints and nerve damage).First,in the human anatomy laboratory,the carpal tunnels of 10 cadaveric hand and forearm specimens were dissected in detail to familiarize themselves with the structure of the carpal tunnel,especially between the MN in the carpal tunnel and the Transverse carpal ligament(TCL).For the anatomical relationship,it is more necessary to clarify the running law of MN and its anti-branch,so as to provide anatomical reference for subsequent intraoperative operations.Then,first take the control group patients underwent traditional incision carpal tunnel lysis.All patients used a vernier caliper with an accuracy of 0.05 mm to measure the TCL thickness during the operation and make a record.The statistical software was used to sort and analyze,and a set of specific Statistical analysis table of TCL thickness data.According to the measured TCL thickness value,the Paine carpal transverse ligament knife was modified.Afterwards,the modified Paine transverse carpal ligament knife was used to perform surgical treatment on the experimental group of patients,and the thickness of the TCL was measured and statistically analyzed.Finally,postoperative follow-up,questionnaire survey and scoring were carried out for the two groups of patients.The evaluation methods include: Gu Yudong Carpal Tunnel Syndrome Function Evaluation Standard [1],Levine Carpal Tunnel Syndrome Questionnaire [2],Kelly Score for Postoperative Follow-up Efficacy,Comparison of two-point discrimination,comparison of incision length,wrist function recovery time,operation time,average hospital stay,postoperative recovery time and postoperative complication rate,etc.,and finally statistical analysis based on follow-up efficacy.Results In the statistical analysis,the TCL thickness of the CTS patients in the control group was(3.98±0.75)mm,and the TCL thickness of the CTS patients in the experimental group was(4.02±0.81)mm measured by the vernier caliper during the operation.There was no significant difference in TCL thickness between the two groups of patients(P>0.05).Secondly,compared with the postoperative efficacy of the experimental group and the control group,the functional evaluation criteria of Gu Yudong carpal tunnel syndrome in the experimental group,Levine carpal tunnel syndrome questionnaire,Kelly score for postoperative follow-up efficacy,comparison of two-point discrimination,incision The evaluation of length comparison,wrist function recovery time,operation time,average hospital stay,postoperative recovery time and postoperative complication rate were superior to the control group,and the difference was statistically significant(P<0.05).Conclusion Due to individual differences in the population,the thickness of TCL varies among individuals.Therefore,when loosening the carpal tunnel to treat patients with CTS caused by TCL compression,a surgical knife that fits the thickness of the TCL should be designed.Under the premise of using the modified Paine transverse carpal ligament knife to perform carpal tunnel lysis,the opening of the knife head fits the TCL more closely,and the postoperative effect of patients is better than that of patients in the traditional incision group.For CTS patients,it is particularly important to use the modified Paine Carpal Transverse Carpal Knife during the operation.This surgical instrument can release the TCL more thoroughly,have a better postoperative effect,and can greatly reduce the occurrence of postoperative complications.Rate,has a more obvious advantage for the treatment of CTS patients. |
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