超声引导下新型手术刀腕管释放术的安全性和有效性：100例尸体标本的比较研究

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2025-05-22 DOI:10.1016/j.jhsg.2025.02.019

Jérôme Garret MD , Jean-Michel Cognet MD , Floris van Rooij MSc , Thomas Apard MD

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引用次数: 0

摘要

目的比较新研制的带导向的手术刀在有和没有超声引导的情况下对尸体标本进行腕管松解手术的安全性和有效性。方法采用无骨折或手术前处理的新鲜冷冻人尸体手100例（平均年龄：71.3±15.8岁，男性60例，女性40例）。将标本分为两组，每组50例，分别由4名经验丰富的手外科医生使用刀和引导器（KeriKnife, KeriMedical）进行超声引导或不超声引导下的腕管松解术。记录供体人口统计和手术侧。术后，每位外科医生报告切开韧带的难度，从1分（容易）到5分（困难），韧带是否完全切开，干预是否对周围结构造成损伤。结果两组患者在年龄、性别、体重、侧位等方面无差异。手术后，外科医生对两组难度的评分相似。超声手术组有1例（2%）韧带不完全切断，而无超声手术组有2例（4%）韧带不完全切断，但差异无统计学意义。无超声组有1例损伤。结论KeriKnife在有或无超声控制的情况下对腕管松解术均有良好的疗效。唯一的医源性损伤发生在无超声控制的手术释放过程中。研究类型/证据水平：治疗性

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Safety and Efficacy of Carpal Tunnel Release Using a New Surgical Knife With and Without Ultrasound Guidance: Comparative Study in 100 Cadaveric Specimens

Purpose

The purpose of this study was to compare the safety and efficacy of the carpal tunnel release surgery in cadaveric specimens, using a newly developed surgical knife incorporating a guide, with and without ultrasound guidance.

Methods

For this study, 100 fresh frozen human cadaveric hands, free from fractures or surgical antecedents, were used (mean age: 71.3 ± 15.8 years, 60 men and 40 women). The specimens were allocated into two groups of 50 to undergo carpal tunnel release with or without ultrasound guidance, using the knife and guide (KeriKnife, KeriMedical) by four experienced hand surgeons. Donor demographics and operated side were recorded. Following surgery, every surgeon reported the difficulty of cutting the ligament on a scale of 1 (easy) to 5 (difficult), whether the ligament was completely cut, and whether the intervention caused any injuries to the surrounding structures.

Results

There were no differences between the groups in terms of age, sex, weight, or side. Following surgery, the surgeons rated the difficulty similarly between the groups. The ligament was incompletely cut in one (2%) specimen that underwent the surgery with ultrasound, whereas it was incomplete in two (4%) that underwent the surgery without ultrasound, although the difference was not statistically significant. Furthermore, there was one injury in the group without ultrasound.

Conclusions

The KeriKnife has shown its effectiveness for carpal tunnel release with or without ultrasound control. The only iatrogenic injury happened during the surgical release without ultrasound control.