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| Study on clinical anatomy of a new surgical method of needle-knife in the treatment of carpal tunnel syndrome |
| ZHOU Qiaoyin1,2 SHEN Yifeng1,2 JIA Yan1,2 QIU Zuyun1,2 SUN Xiaojie1,2 WANG Jianwei3 ZHANG Weiguang3 LI Shiliang1 |
1.Department of Acupuncture and Moxibustion, China-Japan Friendship Hospital, Beijing 100029, China;
2.College of Clinical Medicine, Beijing University of Chinese Medicine, Beijing 100029, China;
3.Teaching and Research Office of Human Anatomy, School of Basic Medical Sciences, Peking University, Beijing 100191, China |
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Abstract Objective To explore the safety and accuracy of the new surgical method of needle-knife in the treamtent of carpal tunnel syndrome, and provide anatomical basis for clinical treatment. Methods Twenty-six adult specimens (15 males and 11 females) of 10% formalin-preserved fixed specimens, aged 60-90 years, with an average of (69.30±15.33) years old, total 52 sides (two of them could not be tested). The specimen was collected from the Donation Center of Peking University School of Basic Medicine. The research period was from November 2017 to May 2018. The operation of acupotomology to release the transverse wrist ligament was simulated in human specimens, and the safety and accuracy values of the two needle points were measured and calculated. Results Safety: The shortest lateral distances L1 and L2 of the released marks by needle-knife from the median nerve were (3.26±0.82) mm (2.13-5.85 mm) and (3.19±0.73) mm (2.04-5.45 mm), respectively. No obvious median nerve injury was found. The shortest distances L3 and L4 of the the released marks by needle-knife from ulnar artery were (3.89±1.17) mm (1.95-7.11 mm) and (3.95±1.14) mm (2.01-6.86 mm), respectively. No ulnar artery injury was observed. The release depth H1 and H2 of needle-knife of the needle insertion point 1 and point 2 was (10.20±1.22) mm (6.56-12.79 mm) and (8.96±1.31) mm (5.73-12.01 mm), respectively, and shadow scratch was found on the surface of the tendon of 6 cases, the tendon injury rate was 12.00%. Accuracy: 39 cases were successful and 11 cases were failed. The length of the release trace was (3.52±0.78) mm (2.04-4.89 mm). The total success rate of release was 78.00%. Conclusion The operational safety of new surgical method of needle-knife in the treatment of carpal tunnel syndrome by releasing transverse carpal ligament is higher, but its accuracy remains to be improved because of its blind vision operation.
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