METHOD FOR REFIXATION OF THUMB THENAR MUSCLES IN OPEN MEDIAN NERVE DECOMPRESSION IN PATIENTS WITH CARPAL TUNNEL SYNDROME Russian patent published in 2024 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to traumatology and orthopaedics, and can be used for refixation of thumb thenar muscles in open median nerve decompression in patients with carpal tunnel syndrome. Longitudinal zigzag incision of skin and fat is 3-4 cm long in a projection of an ulnar part of a carpal tunnel. 1 cm is retreated outwards. Palmar aponeurosis is dissected by an arc-shaped incision with its apex facing the radial side, and an incision plane is directed from the outside to the inside. Ulnar side of the transverse ligament of the wrist is dissected. Moving proximally to the point of intersection with the muscles, the incision enveloping the apex of the muscle attachment is used to dissect a superficial leaf of the ligament together with the muscles and withdraw them to the outside. Complete dissection of transverse ligament of wrist, as well as deep fascia of forearm and palmar aponeurosis is performed. Carpal tunnel is inspected. Median nerve is mobilized. Cut off part of the transverse ligament together with the attached muscles is sutured to the previous place or to the outside up to 3 mm using a U-shaped suture with two locking loops on each side. Three or four separate sutures are used to suture the palmar aponeurosis; skin is closed according to Donati. Epineurotomy is performed in the areas of compression of the median nerve, and a new fixation point of the transverse ligament of the wrist is determined before the incision enveloping the apex of the muscle attachment, and the incision is marked by applying a single mark suture.

EFFECT: method provides reduced injuries of muscles, motor branch of median nerve and ulnar vessels, increased strength of hand grips, reduced pain syndrome due to suturing of muscles to ulnar side of TCL in a state of their physiological tension.

3 cl, 4 dwg, 5 ex