Percutaneous ultrasound guided retrograde lacertus fibrosus release

IF 0.9 4区医学 Q4 ORTHOPEDICS

Hand Surgery & Rehabilitation Pub Date : 2025-05-01 DOI:10.1016/j.hansur.2025.102130

Thomas Apard , Vincent Martinel

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引用次数: 0

Abstract

The purpose of this technical note is to present a microinvasive percutaneous ultrasound-guided release of the lacertus fibrosus of the biceps brachii for lacertus syndrome, i.e., median nerve entrapment at the elbow.

Using the Walant technique (wide awake local anesthesia and no tourniquet), the entry point is made with a 19G needle to introduce the hook distally from the distal border of the lacertus fibrosus. The hook is then slid along the pronator teres fascia to the proximal border of the lacertus fibrosus. The cut is ultrasound-guided from proximal to distal. The cut is effective when the back of the force is observed in the 3 targeted muscles (flexor carpi radialis, flexor pollicis longus and flexor digitorum profundus).

This minimally invasive surgical procedure is efficient in terms of lacertus fibrosus sectioning. Real-time ultrasound monitoring may improve safety. The technique could be considered as a new ultrasound-guided alternative to open surgery.

When performed superficially to the pronator teres muscle under WALANT anesthesia and percutaneously, ultrasound-guided lacertus fibrosus release may be an effective treatment for lacertus syndrome in the interventional ultrasound unit.

查看原文本刊更多论文

经皮超声引导逆行纤维撕脱术。

本技术报告的目的是介绍一种微创经皮超声引导下的肱二头肌纤维lacertus松解术，用于治疗肘正中神经卡压的lacertus综合征。采用Walant技术（完全清醒局部麻醉，不带止血带），用19G针从纤维撕裂肌远端边缘远端引入钩入点。然后将钩沿旋前圆肌筋膜滑至纤维角肌的近端。切口由近端到远端超声引导。当在3个目标肌肉（桡腕屈肌、拇长屈肌和指深屈肌）中观察到力的后部时，切割是有效的。这种微创手术是有效的纤维撕裂肌切开术。实时超声监测可以提高安全性。该技术可以被认为是一种新的超声引导下的开放手术的选择。在WALANT麻醉下经皮对旋前圆肌进行表面手术，超声引导下的纤维撕角松解术可能是介入超声单元治疗撕角综合征的有效方法。

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

Hand Surgery & Rehabilitation Medicine-Surgery

CiteScore

1.70

自引率

27.30%

发文量

审稿时长

49 days

期刊介绍： As the official publication of the French, Belgian and Swiss Societies for Surgery of the Hand, as well as of the French Society of Rehabilitation of the Hand & Upper Limb, ''Hand Surgery and Rehabilitation'' - formerly named "Chirurgie de la Main" - publishes original articles, literature reviews, technical notes, and clinical cases. It is indexed in the main international databases (including Medline). Initially a platform for French-speaking hand surgeons, the journal will now publish its articles in English to disseminate its author''s scientific findings more widely. The journal also includes a biannual supplement in French, the monograph of the French Society for Surgery of the Hand, where comprehensive reviews in the fields of hand, peripheral nerve and upper limb surgery are presented. Organe officiel de la Société française de chirurgie de la main, de la Société française de Rééducation de la main (SFRM-GEMMSOR), de la Société suisse de chirurgie de la main et du Belgian Hand Group, indexée dans les grandes bases de données internationales (Medline, Embase, Pascal, Scopus), Hand Surgery and Rehabilitation - anciennement titrée Chirurgie de la main - publie des articles originaux, des revues de la littérature, des notes techniques, des cas clinique. Initialement plateforme d''expression francophone de la spécialité, la revue s''oriente désormais vers l''anglais pour devenir une référence scientifique et de formation de la spécialité en France et en Europe. Avec 6 publications en anglais par an, la revue comprend également un supplément biannuel, la monographie du GEM, où sont présentées en français, des mises au point complètes dans les domaines de la chirurgie de la main, des nerfs périphériques et du membre supérieur.