Ultrasound-guided release of the fibro-osseous tunnels around the wrist and hand: A technical review.

IF 1.8 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Nishith Kumar, Alfa Shamim Saifi, Upinderjeet Singh, Divesh Jalan, Skand Sinha, Dharmendra Kumar Singh
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引用次数: 0

Abstract

Fibro-osseous tunnels allow the unhindered passage of the neurovascular bundle and sliding tendons across the mobile joint. Release of the fibro-osseous tunnels is performed for entrapment neuropathy and stenosing tenosynovitis which occur as a result of increase in the volume/pressure within these tunnels. The common surgical principle in all these pathologies is releasing the pressure by transecting the fascial covering. Primarily these pathologies are treated with open surgery but are potentially amenable to curative percutaneous ultrasound (US) guided release procedures. US is the preferable guiding modality due to its high resolution and real-time demonstration of the anatomy and needle positioning. The advantages of these minimally invasive techniques are lower risk of wound breakdown, quicker healing, reduced post-procedural pain, reduced complications, and a quicker return to normal activity. The release of the tunnel may be achieved by sectioning the thickened pulley or retinaculum with the aid of the needle bevel or surgical-grade thread which are universally available, economical, and equally effective. This article reviews the literature, our institutional experience and the rationale of US-guided percutaneous release procedures in wrist and hand including thread and partial needle carpal tunnel release for carpal tunnel syndrome, needle release for trigger finger, partial needle release for de Quervain's tenosynovitis and needle aponeurotomy for Dupuytren's contracture.

超声引导下腕部和手部纤维骨隧道的释放技术综述。
纤维骨隧道允许神经血管束和滑动肌腱在活动关节上不受阻碍地通过。纤维-骨性隧道的释放是用于卡压性神经病和狭窄性腱鞘炎,这是由于这些隧道内的体积/压力增加而发生的。所有这些疾病的常见手术原则是通过横切筋膜覆盖层来释放压力。这些病变主要采用开放手术治疗,但也有可能采用经皮超声(US)引导的治疗性释放手术。超声成像由于其高分辨率和实时显示解剖和针的定位而成为首选的引导方式。这些微创技术的优点是伤口破裂的风险更低,愈合更快,术后疼痛减少,并发症减少,恢复正常活动更快。隧道的释放可以通过在针斜面或手术级螺纹的帮助下切开加厚的滑轮或支持带来实现,这些方法普遍可用,经济且同样有效。本文回顾了文献、我们的机构经验和us引导下手腕和手部经皮松解术的基本原理,包括腕管综合征的线和部分针松解术、扳机指的针松解术、de Quervain肌腱滑膜炎的部分针松解术和Dupuytren挛缩的针腱切开术。
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
British Journal of Radiology
British Journal of Radiology 医学-核医学
CiteScore
5.30
自引率
3.80%
发文量
330
审稿时长
2-4 weeks
期刊介绍: BJR is the international research journal of the British Institute of Radiology and is the oldest scientific journal in the field of radiology and related sciences. Dating back to 1896, BJR’s history is radiology’s history, and the journal has featured some landmark papers such as the first description of Computed Tomography "Computerized transverse axial tomography" by Godfrey Hounsfield in 1973. A valuable historical resource, the complete BJR archive has been digitized from 1896. Quick Facts: - 2015 Impact Factor – 1.840 - Receipt to first decision – average of 6 weeks - Acceptance to online publication – average of 3 weeks - ISSN: 0007-1285 - eISSN: 1748-880X Open Access option
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