RESUMO
Limited-open carpal tunnel release was performed in ten cadaver arms using the "Safeguard" system. The "Safeguard" guide was intentionally placed off of the longitudinal middle/ring finger axis, either in 15 degrees of radial deviation or 15 degrees of ulnar deviation. Despite the errant placement, carpal tunnel release was performed without damage to any neurovascular structure. The proximity of neurovascular structures to the middle/ring finger axis was measured in all ten cadaver specimens. From this, a "safe-zone" was defined for endoscopic or limited-open carpal tunnel release. The "safe-zone" expands when surgery is performed from distal to proximal. The area of the "safe-zone" is greatest when a protective guide is placed between the bursal sac of the carpal canal and the flexor retinaculum.
Assuntos
Síndrome do Túnel Carpal/cirurgia , Traumatismos da Mão/prevenção & controle , Complicações Intraoperatórias/prevenção & controle , Instrumentos Cirúrgicos , Cadáver , Endoscopia , Mãos/irrigação sanguínea , Mãos/inervação , Humanos , Fatores de Risco , SegurançaRESUMO
Recent advances in arthroscopic surgery techniques and instrumentation have enabled the surgeon to improve the treatment of wrist pathology. The arthroscopist can now perform a proximal row carpectomy or radial styloidectomy with minimal dissection and potentially less morbidity. The surgery requires a high level of skill from the surgeon. This is an area of medicine that is still evolving. Long-term studies are lacking but short-term results are promising. In the near future, the role of arthroscopy will better be defined as more research becomes available.