METHOD FOR MEDIAN NERVE DECOMPRESSION IN CASE OF CARPAL TUNNEL SYNDROME

摘要

FIELD: medicine.;SUBSTANCE: before surgery, levels of median nerve entrance into and exit from the carpal canal, as well as its area of maximum compression are determined using ultrasound and electroneuromyographic (ENMG) studies. Skin incision is performed on the skin fold transverse to the carpal canal, length is 10-15 mm. Focusing on the palmaris longus tendon, isolation and blunt transverse disengagement of carpal ligament fibers and longitudinal incision of the proximal portion of carpal ligament fibers are performed to visualize the median nerve in the proximal direction. The soft tissue is separated from the carpal ligament distally using a cotton swab and surgical scissors with blunt ends. Then, focusing on skin tags, the distal portion of the carpal ligament is dissected longitudinally, and the median nerve is freed along its entire length under the electroneuromyographic supervision. Electroneuromyographic supervision of nerve conducting function recovery is performed, and in case of recovery, the previously isolated palmar subcutaneous fat fragments are laid into the edge diastasis of the carpal ligament on the median nerve along its entire length, and then the wound edges are brought together and sealed with a surgical glue.;EFFECT: method reduces intraoperative and postoperative complications, which is achieved by the stated sequence of operation techniques.;2 cl, 3 ex