Nerve decompression for carpal tunnel syndrome

Carpal tunnel syndrome, also known as late-onset median nerve palsy, is a "cumulative traumatic disorder". It occurs in office women between the ages of 30 and 50. It refers to the median nerve of the human body entering the meridian of the palm of the hand. Symptoms such as index finger, middle finger pain, numbness and thumb muscle weakness after compression. The carpal tunnel is a bony fibrous tube with scaphoid and multi-corner bone on the temporal side; pea bone and hook-shaped bone on the ulnar side; skull, scaphoid and small polygonal bone on the dorsal side; transverse ligament of the wrist on the volar side . In the carpal tunnel, there are flexor hallucis longus, finger flexor tendon, deep flexor tendon and median nerve. Any cause of squeezing or reducing the volume of the carpal tunnel can compress the median nerve and cause carpal tunnel syndrome. Coles fracture malunion, anterior lumbar dislocation, infection or trauma caused by soft tissue edema, thickened transverse carpal ligament, ganglion cyst, lipoma, xanthoma, some systemic diseases such as obesity, diabetes, thyroid dysfunction, amyloidosis or Reynaud disease can sometimes be combined with carpal tunnel syndrome. In the early stage of the lesion, the edema and hyperemia of the median nerve are gradually caused by the compression of the nerve, the axon compression and the disappearance of the myelin sheath. Finally, the nerve tissue is transformed into fibrous tissue, and the nerve inner tube It disappears and is replaced by collagen tissue, becoming an irreversible change. The reason why this kind of illness has quickly become an increasingly common modern civilization disease is that the modern lifestyle has changed dramatically, and more and more people are exposed to and used computers for a long time. The main cause is the use of computer users, such as Internet users, to access the computer for a long time every day, repeated typing on the keyboard and moving the mouse. The wrist joints gradually form the paralysis and pain of the wrist due to long-term intensive, repeated and excessive activities. If you ignore this symptom for a long time, it may cause nerve damage and hand muscle atrophy. Treatment of diseases: carpal tunnel syndrome carpal tunnel syndrome Indication Suitable for the index finger, middle finger pain, numbness and thumb muscle weakness and other symptoms. Contraindications Severe compression, post-traumatic neuritis, space-occupying lesions, habitual spondylolisthesis. Preoperative preparation One week before the operation, the patients were fed nutritious and digestible foods. Those with weak constitution can supplement the appropriate amount of protein and vitamins by oral or intravenous infusion. 3 days before surgery, routine orthopedic preparation of skin, that is, on the first day and the second day, wash the area with soapy water, disinfect the skin with iodine and ethanol, and then use a sterile towel to wrap it; on the third day, shave the hair, brush and disinfect. Wrap with a sterile towel. Carefully check the determined preparations before the operation. A sedative can be given that night to ensure a good sleep. If the body temperature rises, or women's menstrual cramps, etc., the date of surgery is delayed. Before entering the operating room, the patient empties the urine; the catheter is placed in accordance with the length of the operation, so that the bladder is in an empty state. Surgical procedure The skin and subcutaneous tissue were excised to reveal the transverse ligament of the scapula and the median nerve. The transverse ligament of the volar arm is removed, and the median nerve under the ligament is compacted and hardened. The proximal ligament of the ligament becomes thick, edematous, and congested. The outer membrane is removed to release the nerve. If the tendon synovium is thick, some of the synovial membrane can be removed. Close the wound. complication Any cause of squeezing or reducing the volume of the carpal tunnel can compress the median nerve and cause carpal tunnel syndrome, Coles fracture malunion, anterior lumbar dislocation, soft tissue edema caused by infection or trauma, thickened transverse ligament of the wrist, ganglion cyst, fat Tumor, xanthomas, some systemic diseases such as obesity, diabetes, thyroid dysfunction, amyloidosis or Reynaud disease can sometimes be combined with carpal tunnel syndrome, in the early stage of the lesion, the edema and congestion of the median nerve, gradually due to oppression Ischemia causes fibrosis in the nerve, compression of the axons and disappearance of the myelin sheath. Finally, the nerve tissue is transformed into fibrous tissue, and the inner nerve tube disappears and is replaced by collagen tissue, which becomes an irreversible change.

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