進階搜尋


   電子論文尚未授權公開,紙本請查館藏目錄
(※如查詢不到或館藏狀況顯示「閉架不公開」,表示該本論文不在書庫,無法取用。)
系統識別號 U0026-2808201915293900
論文名稱(中文) 超音波在腕隧道症候群及扳機指之臨床應用
論文名稱(英文) Clinical Applications of Ultrasonography in Carpal Tunnel Syndrome and Trigger Finger
校院名稱 成功大學
系所名稱(中) 生物醫學工程學系
系所名稱(英) Department of BioMedical Engineering
學年度 107
學期 2
出版年 108
研究生(中文) 吳東泰
研究生(英文) Tung-Tai Wu
學號 P88971084
學位類別 博士
語文別 英文
論文頁數 69頁
口試委員 指導教授-蘇芳慶
口試委員-郭立杰
口試委員-楊岱樺
口試委員-張志涵
口試委員-周一鳴
口試委員-邱浩遠
中文關鍵字 經皮鬆解  腕隧道症候群  超音波  腕管壓力  扳機指  Al 滑車  屈指肌腱 
英文關鍵字 Percutaneous release  carpal tunnel syndrome  ultrasonography  carpal tunnel pressure  trigger finger  ultrasound  Al pulley  flexor tendon 
學科別分類
中文摘要 腕隧道症候群與扳機指為兩種非常常見的手部疾患,且兩者有一定程度的共病性。而腕隧道症候群的致病機制可能是腕管(carpal tunnel)內的腕管壓力的升高所導致。目前,其中一種治療方法是以腕管減壓術為主,透過切開橫腕骨韌帶來治療腕隧道症候群。而扳機指患者在掌指關節附近常有疼痛感且伴隨著手指頭於彎曲和伸直時在 A1 滑車近端區域有卡住、夾住或彈響的感覺。其中A1 滑車-肌腱系統的不相稱可能是引發扳機指的機制。在本論文中,研究設計分為三個部分,除了透過超音波輔助手術技術治療這些疾病外,更利用此一特殊手術方式來量測腕管內的壓力及評估A1 滑車-肌腱系統的不相稱現象,分別描述如下:
超音波導引經皮腕隧道鬆解:本部分研究的目的是呈現利用超音波輔助經皮腕管解離手術(percutaneous carpal tunnel release, PCTR)技術治療腕隧道症候群患者及其臨床結果。方法:我們使用先前於大體研究中所定義的解剖標誌包含安全區、定位、大小估計和橫腕韌帶的範圍,於91 位腕隧道症候群患者使用此一手術技術。追蹤包括四個時間點(1 週、2 個月、6 個月和12 個月),最終隨訪時間平均為22.5 個月。結果:感覺異常在治療後1 週、2 個月、6 個月和12 個月時分別減少約76.8%、93.4%、100%和100%。24.2%患者在1 週內曾有過中度疼痛,至2 個月內為6.6%,治療後12 個月內則僅剩1.1%。在最終隨訪時,兩隻手腕被評為不滿意:一隻手腕中度疼痛,但無感覺異常,另一隻手腕治療後14 個月復發。無治療中或治療後併發症狀。結論:超音波輔助經皮腕管解離手術是一種安全且有效的方法,但技術要求高,需要接受嚴密的教育與訓練才能熟悉使用。腕管壓-預後相關性:由於較少相關文獻提出利用超音波導引穿刺法研究超音波輔助經皮腕管解離手術對腕管壓力的影響,並建立腕管壓力與臨床結果之間的關係。因此,這部分研究的目的是評估腕管壓力的臨床結果與經超音波輔助經皮腕管解離手術治療後正中神經橫截面積的相關性。方法:一系列原發性腕隧道症候群患者量測術前、術後腕管壓力,及評估超音波下正中神經橫截面積和波士頓腕隧道量表直至治療後12 個月。結果:在超音波輔助經皮腕管解離手術後,36 例病患之37 隻症狀手的腕管壓力有顯著下降。對於輕度和中度神經電生理分級的患者,治療後的腕管壓力較低,腕管壓力降低率較高。手術後,波士頓腕隧道量表分數在一個月的追蹤中顯著改善,正中神經橫截面積直到3 個月的追蹤才顯著改善。術前腕管壓力與術前正中神經橫截面積評分和正中神經橫截面積顯著正相關。直到手術後12 個月,術後即時的腕管壓仍與正中神經橫截面積顯著正相關,但僅與術後1 個月的波士頓腕隧道量表分數成正相關。結論:術後即時的腕管壓可能可以用於預測短期術後功能性結果和正中神經橫截面積。肌腱-A1 滑車不對稱:本部分研究的目的是:利用非侵入性的超音波系統探討屈指肌腱的橫截面積和A1 滑車的厚度於扳機指與對側正常指分別於手指彎曲與伸直兩種姿勢下的相對關係。方法:本研究檢查了17 位扳機指患者的患側手指與對側正常手指。分別在掌指關節0°和彎曲60°時兩種姿勢觀察屈指肌腱及A1 滑車的超音波影像。結果:與對側正常手指相比,在掌指關節0°和彎曲60°時扳機指屈指肌腱橫截面積及A1滑車厚度皆顯著增加。此外,扳機指A1 滑車厚度於掌指關節彎曲60°時明顯大於彎曲0°時,但屈指肌腱橫截面積無論在哪種角度皆無顯著差異。結論:我們的結果顯示扳機指會造成A1 滑車增厚的和較大的屈指肌腱橫截面積。而扳機指在掌指關節彎曲時,A1 滑車與屈指肌腱橫截面積的不對稱變化可能是造成扳機現象的原因。
英文摘要 Carpal tunnel syndrome (CTS) and trigger digit (TD) both are common hand disorder with a significant co-incidence. The elevated carpal tunnel pressure (CTP) within the carpal tunnel is a possible mechanism to result in the CTS. Carpal tunnel release is one of the treatments for CTS by transecting the transverse carpal ligament (TCL) to relieve the symptoms of CTS. The patients with TD usually present pain at the metacarpophalangeal(MCP) joint and locking, catching or snapping sensation at the proximal portion of first annular (A1) pulley of the affected finger during flexion and extension. The mismatch of the A1 pulley-tendon sheath system is a possible mechanism to cause the triggering phenomenon. In this thesis, study designs were divided into three parts. The concept of these studies is to solve the clinical scenario using ultrasonography. We treated CTS and TD using ultrasonography-assisted percutaneous release in our daily practice, and furthermore measured the CTP using the unique technique. Finally, we evaluated the mismatch of the A1 pulley-tendon sheath system using ultrasonography. The three parts were described as follows:US-assisted PCTR:The purpose of this part of the study is to present the technique and the results of an ultrasonographically guided percutaneous carpal tunnel release (PCTR) in a consecutive series of patients with carpal tunnel syndrome. Methods: We used previously defined landmarks with the "safe zones", localization, estimated size, and extent of the transverse carpal ligament for this prospective clinical study of 91 consecutive cases of carpal tunnel release treated with this technique. The follow-up consisted of four time points(1 week and 2, 6, and 12 months) and a final evaluation in an average 22.5 months. Results:
The sensory disturbances disappeared in 76.8, 93.4, 100, and 100% of the patients in 1 week and 2, 6, and 12 months postoperatively, and 24.2% experienced moderate pain within 1 week, 6.6% within 2 months, and 1.1% within 12 months after the operation. In the final evaluation, two hands were graded as unsatisfactory: one had moderate wrist pain without sensory disturbance and one had a recurrence 14 months after the operation. There was no intra- or postoperative complication. Conclusions: Ultrasonographically assisted PCTR is a safe and effective procedure, but it is technically demanding and requires substantial training to be proficient in its use. CTP-outcomes correlation: Since there were no studies to investigate the effect of ultrasonographically guided percutaneous carpal tunnel release (UCTR) on CTP by percutaneous ultrasound-guided needle puncture method and establish the relationship between CTP and clinical outcomes.The aim of this part of the study is to evaluate the correlation of carpal tunnel pressure (CTP) with clinical outcomes and cross-sectional area of median nerve (CSAMN) following ultrasonographically guided percutaneous carpal tunnel release (UCTR). Methods: Serial patients with idiopathic CTS were enrolled. CSAMN under ultrasound examination and Boston Carpal Tunnel Questionnaire (BCTQ)
were evaluated until twelve months postoperatively. Results: The CTP in 37 hands of 36 patients significantly decreased after UCTR. There were the lower post-operative CTP and the higher decrease ration of CTP in patients with the mild and moderate electrodiagnostic grades. After surgery, BCTQ score significantly improved at one-month follow-up, and CSAMN did not significantly improve until three-month follow-up. The pre-operative CTP was significantly positively correlated with pre-operative BCTQ score and CSAMN. The immediately post-operative CTP was still significantly positively correlated with CSAMN until twelve months after surgery, but only with post-operative BCTQ at one-month followup.
Conclusions: Therefore, the immediate postoperative CTP might predict the short-term postoperative functional outcomes and CSAMN. Tendon-A1 pulley mismatch: The aim of this study was to evaluate and to compare the cross-sectional area (CSA) of flexor digitorum tendons and the thickness of A1 pulleys between contralateral normal digits and trigger digits at positions of finger flexion and extension using a noninvasive ultrasound system. Methods: Seventeen affected fingers of seventeen trigger finger patients who involved the trigger finger in one hand were examined in this study. Seventeen contralateral normal digits without symptoms of trigger finger were
examined. The sonographic appearances of flexor digitorum tendons and A1 pulley were observed at two positions of 0˚ and 60˚ metacarpophalangeal (MCP) joint flexion. Results:
The findings of this study indicate that CSA of flexor digitorum tendons and A1 pulley thickness were significantly larger in both positions of 0° and 60° flexion of MCP joint compared to contralateral normal digits (p< 0.01). In trigger digits, there was a significantly thicker A1 pulley at 60° flexion of MCP joint than that at 0° flexion (p< 0.01), but no
significant change on CSA of flexor tendons. Conclusions: Our results suggested that trigger digits lead to the thicker A1 pulley and larger CSA of the flexor digitorum tendons. The mismatch in volume change between CSA of flexor digitorum tendons and A1 pulley
thickness during MCP flexion may lead to the trigger phenomenon.
論文目次 摘要 ····································································· I
Abstract ································································ III
致謝 ····································································· VI
Content ································································· VII
List of Table ··························································· XI
List of Figure ·························································· XII
Chapter 1 Introduction ··················································· 1
1.1 RESEARCH BACKGROUD ······································· 2
1.1.1 Carpal tunnel syndrome (CTS) ······························· 2
1.1.2 CTS and carpal tunnel pressure(CTP) ······················ 2
1.1.3 Trigger digit (TD) ··············································· 3
1.2 MOTIVATIONS AND OBJECTIVES ··························· 4
1.2.1 US-assisted PCTR ··············································· 4
1.2.2 CTP-outcomes correlation ····································· 5
1.2.3 Tendon-A1 pulley mismatch ··································· 5
Chapter 2 Ultrasonographically Guided Percutaneous Carpal
Tunnel Release: Early Clinical Experiences and Outcomes · 6
2.1 INTRODUCTION ···················································· 7
2.2 MATERIALS AND METHODS ··································· 9
2.2.1 Patient population ··············································· 9
2.2.2 Instruments and operative technique ························ 9
2.2.3 After-care ························································· 18
2.2.4 Assessing the result and outcome measurement ··········· 18
2.3 RESULTS ······························································· 20
2.3.1 US-assisted PCTR ··············································· 20
2.3.2 Symptomative relief and postoperative pain and tenderness
······································································································· 21
2.3.3 Sensory and strength testing··································· 21
2.3.4 Scar and wound healing ······································· 24
2.3.5 Complications ···················································· 24
2.3.6 Final outcomes ·················································· 24
2.4 DISCUSSIONS ························································ 25
2.5 CONCLUSION ························································ 30
Chapter 3 The Correlation Of Carpal Tunnel Pressure With
Clinical Outcomes Following Ultrasonographically-Guided
Percutaneous CarpalTunnel Release ································· 31
3.1 INTRODUCTION ···················································· 32
3.2 MATERIALS AND METHODS ··································· 34
3.2.1 Participants ······················································· 34
3.2.2 Carpal tunnel pressure measurement and percutaneous
ultrasound-guided carpal tunnel release ··························· 34
3.2.3 CSA of median nerve and Functional Outcome ··········· 35
3.2.4 Statistical analysis ······························································· 36
3.3 RESULTS ······························································· 37
3.3.1 Demographic data ··············································· 37
3.3.2 Outcomes after UCTR ························································· 37
3.3.3 Correlation among CTP, CSA of median nerve, and functional
outcomes ······················································································· 38
3.4 DISCUSSIONS ························································ 44
3.5 CONCLUSIONS ······················································ 48
Chapter 4Effect of Metacarpophalangeal Joint Positionon A1 Pulley
and Flexor Digitorum Tendons in Trigger Digits ············· 49
4.1 INTRODUCTION ···················································· 50
4.2 MATERIALS AND METHODS ··································· 52
4.2.1 Patients ···························································· 52
4.2.2 Ultrasound examination and measurements ····················· 54
4.2.3 Statistical analysis ······························································· 55
4.3 RESULTS ······························································· 56
4.3.1 Trigger digits versus normal digits ··························· 56
4.3.2 The effect of MCP posture ·················································· 56
4.4 DISCUSSIONS ························································ 59
4.5 LIMITATIONS ························································ 61
4.6 CONCLUSIONS ······················································ 61
References ····································································· 62
參考文獻 1. Olney RK. Carpal tunnel syndrome: complex issues with a "simple" condition. Neurology. 2001 Jun 12;56(11):1431-2. Epub 2001/06/13.
2. Padua L, Coraci D, Erra C, Pazzaglia C, Paolasso I, Loreti C, et al. Carpal tunnel syndrome: clinical features, diagnosis, and management. The Lancet Neurology. 2016
Nov;15(12):1273-84. Epub 2016/10/19.
3. Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosen I. Prevalence of carpal tunnel syndrome in a general population. Jama. 1999 Jul 14;282(2):153-8. Epub
1999/07/20.
4. Benson LS, Bare AA, Nagle DJ, Harder VS, Williams CS, Visotsky JL. Complications of endoscopic and open carpal tunnel release. Arthroscopy : the journal of arthroscopic
& related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 2006 Sep;22(9):919-24, 24.e1-2. Epub 2006/09/06.
5. Boeckstyns ME, Sorensen AI. Does endoscopic carpal tunnel release have a higher rate of complications than open carpal tunnel release? An analysis of published
series. Journal of hand surgery (Edinburgh, Scotland). 1999 Feb;24(1):9-15. Epub 1999/04/06.
6. Concannon MJ, Brownfield ML, Puckett CL. The incidence of recurrence after endoscopic carpal tunnel release. Plastic and reconstructive surgery. 2000 Apr;105(5):1662-5. Epub 2000/05/16.
7. Forman DL, Watson HK, Caulfield KA, Shenko J, Caputo AE, Ashmead D. Persistent or recurrent carpal tunnel syndrome following prior endoscopic carpal tunnel release.
The Journal of hand surgery. 1998 Nov;23(6):1010-4. Epub 1998/12/16.
8. Ibrahim I, Khan WS, Goddard N, Smitham P. Carpal tunnel syndrome: a review of the recent literature. The open orthopaedics journal. 2012;6:69-76. Epub 2012/04/04.
9. Boya H, Ozcan O, Ozteki NH. Long-term complications of open carpal tunnel release. Muscle & nerve. 2008 Nov;38(5):1443-6. Epub 2008/10/25.
10. Kluge W, Simpson RG, Nicol AC. Late complications after open carpal tunnel decompression. Journal of hand surgery (Edinburgh, Scotland). 1996 Apr;21(2):205-7. Epub 1996/04/01.
11. Okutsu I, Ninomiya S, Takatori Y, Ugawa Y. Endoscopic management of carpal tunnel syndrome. Arthroscopy : the journal of arthroscopic & related surgery : official
publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 1989;5(1):11-8. Epub 1989/01/01.
12. Chow JC. Endoscopic release of the carpal ligament: a new technique for carpal tunnel syndrome. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 1989;5(1):19-24. Epub 1989/01/01.
13. Abrams R. Endoscopic versus open carpal tunnel release. The Journal of hand surgery. 2009 Mar;34(3):535-9. Epub 2009/03/05.
14. Scholten RJ, Mink van der Molen A, Uitdehaag BM, Bouter LM, de Vet HC. Surgical treatment options for carpal tunnel syndrome. The Cochrane database of systematic reviews. 2007 Oct 17(4):Cd003905. Epub 2007/10/19.
15. Thoma A, Veltri K, Haines T, Duku E. A meta-analysis of randomized controlled trials comparing endoscopic and open carpal tunnel decompression. Plastic and reconstructive surgery. 2004 Oct;114(5):1137-46. Epub 2004/10/01.
16. Keir PJ, Rempel DM. Pathomechanics of peripheral nerve loading. Evidence in carpal tunnel syndrome. Journal of hand therapy : official journal of the American Society of
Hand Therapists. 2005 Apr-Jun;18(2):259-69. Epub 2005/05/14.
17. Rempel DM, Diao E. Entrapment neuropathies: pathophysiology and pathogenesis. Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology. 2004 Feb;14(1):71-5. Epub 2004/02/05.
18. Gumustas SA, Ekmekci B, Tosun HB, Orak MM, Bekler HI. Similar effectiveness of the open versus endoscopic technique for carpal tunnel syndrome: a prospective randomized trial. European journal of orthopaedic surgery & traumatology : orthopedie traumatologie. 2015 Dec;25 (8):1253-60. Epub 2015/09/01.
19. Murthy PG, Goljan P, Mendez G, Jacoby SM, Shin EK, Osterman AL. Mini-open versus extended open release for severe carpal tunnel syndrome. Hand (New York, NY). 2015
Mar;10(1):34-9. Epub 2015/03/15.
20. Sanz J, Lizaur A, Sanchez Del Campo F. Postoperative changes of carpal canal pressure in carpal tunnel syndrome: a prospective study with follow-up of 1 year. Journal of
hand surgery (Edinburgh, Scotland). 2005 Dec;30(6):611-4. Epub 2005/08/23.
21. Uchiyama S, Yasutomi T, Momose T, Nakagawa H, Kamimura M, Kato H. Carpal tunnel pressure measurement during two-portal endoscopic carpal tunnel release. Clinical
biomechanics (Bristol, Avon). 2010 Nov;25(9):893-8. Epub 2010/07/27.
22. Lee HJ, Kim IS, Sung JH, Lee SW, Hong JT. Intraoperative dynamic pressure measurements in carpal tunnel syndrome: Correlations with clinical signs. Clinical
neurology and neurosurgery. 2016 Jan;140:33-7. Epub 2015/12/01.
23. Patel MR, Bassini L. Trigger fingers and thumb: when to splint, inject, or operate. The Journal of hand surgery. 1992 Jan;17(1):110-3. Epub 1992/01/01.
24. Ryzewicz M, Wolf JM. Trigger digits: principles, management, and complications. The Journal of hand surgery. 2006 Jan;31(1):135-46. Epub 2006/01/31.
25. Bodor M, Flossman T. Ultrasound-guided first annular pulley injection for trigger finger. Journal of ultrasound in medicine : official journal of the American Institute of
Ultrasound in Medicine. 2009 Jun;28(6):737-43. Epub 2009/05/28.
26. Akhtar S, Bradley MJ, Quinton DN, Burke FD. Management and referral for trigger finger/thumb. BMJ (Clinical research ed). 2005 Jul 2;331(7507):30-3. Epub 2005/07/05.
27. Sampson SP, Badalamente MA, Hurst LC, Seidman J. Pathobiology of the human A1 pulley in trigger finger. The Journal of hand surgery. 1991 Jul;16(4):714-21. Epub 1991/07/01.
28. Tagliafico A, Resmini E, van Holsbeeck MT, Derchi LE, Ferone D, Martinoli C. Sonographic depiction of trigger fingers in acromegaly. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. 2009 Nov;28(11):1441-6. Epub 2009/10/27.
29. Rottgers SA, Lewis D, Wollstein RA. Concomitant presentation of carpal tunnel syndrome and trigger finger. Journal of brachial plexus and peripheral nerve injury.
2009 Aug 25;4:13. Epub 2009/08/27.
30. Hayashi M, Uchiyama S, Toriumi H, Nakagawa H, Kamimura M, Miyasaka T. Carpal tunnel syndrome and development of trigger digit. Journal of clinical neuroscience :
official journal of the Neurosurgical Society of Australasia. 2005 Jan;12(1):39-41. Epub 2005/01/11.
31. Tai TW, Wu CY, Su FC, Chern TC, Jou IM. Ultrasonography for diagnosing carpal tunnel syndrome: a meta-analysis of diagnostic test accuracy. Ultrasound in medicine & biology. 2012 Jul;38(7):1121-8. Epub 2012/05/01.
32. Chern TC, Jou IM, Yen SH, Lai KA, Shao CJ. Cadaveric study of sonographically assisted percutaneous release of the A1 pulley. Plastic and reconstructive surgery. 2005
Mar;115(3):811-22. Epub 2005/02/26.
33. Jou IM, Chern TC. Sonographically assisted percutaneous release of the a1 pulley: a new surgical technique for treating trigger digit. Journal of hand surgery (Edinburgh,
Scotland). 2006 Apr;31(2):191-9. Epub 2005/12/27.
34. Kuo LC, Su FC, Tung WL, Lai KY, Jou IM. Kinematical and functional improvements of trigger digits after sonographically assisted percutaneous release of the A1 pulley. Journal of orthopaedic research : official publication of the Orthopaedic Research Society. 2009 Jul;27(7):891-6. Epub 2009/01/01.
35. Wu KC, Chern TC, Jou IM. Ultrasound-assisted percutaneous trigger finger release: it is safe. Hand (New York, NY). 2009 Sep;4(3):339. Epub 2009/03/18.
36. Chern TC, Jou IM, Chen WC, Wu KC, Shao CJ, Shen PC. An ultrasonographic and anatomical study of carpal tunnel, with special emphasis on the safe zones in percutaneous release. The Journal of hand surgery, European volume. 2009
Feb;34(1):66-71. Epub 2009/01/09.
37. Chern TC, Wu KC, Huang LW, Shao CJ, Wu TT, Kuo LC, et al. A cadaveric and preliminary clinical study of ultrasonographically assisted percutaneous carpal tunnel
release. Ultrasound in medicine & biology. 2014 Aug;40(8):1819-26. Epub 2014/05/07.
38. Atroshi I, Larsson GU, Ornstein E, Hofer M, Johnsson R, Ranstam J. Outcomes of endoscopic surgery compared with open surgery for carpal tunnel syndrome among employed patients: randomised controlled trial. BMJ (Clinical research ed). 2006 Jun 24;332(7556):1473. Epub 2006/06/17.
39. Kang HJ, Koh IH, Lee TJ, Choi YR. Endoscopic carpal tunnel release is preferred over mini-open despite similar outcome: a randomized trial. Clinical orthopaedics and
related research. 2013 May;471(5):1548-54. Epub 2012/10/27.
40. Vasiliadis HS, Xenakis TA, Mitsionis G, Paschos N, Georgoulis A. Endoscopic versus open carpal tunnel release. Arthroscopy : the journal of arthroscopic & related
surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 2010 Jan;26(1):26-33. Epub 2010/02/02.
41. Varitimidis SE, Herndon JH, Sotereanos DG. Failed endoscopic carpal tunnel release. Operative findings and results of open revision surgery. Journal of hand surgery
(Edinburgh, Scotland). 1999 Aug;24(4):465-7. Epub 1999/09/03.
42. Werner RA, Andary M. Electrodiagnostic evaluation of carpal tunnel syndrome. Muscle & nerve. 2011 Oct;44(4):597-607. Epub 2011/09/17.
43. Seiler JG, 3rd, Barnes K, Gelberman RH, Chalidapong P. Endoscopic carpal tunnel release: an anatomic study of the two-incision method in human cadavers. The Journal of hand surgery. 1992 Nov;17(6):996-1002. Epub 1992/11/01.
44. Nakamichi K, Tachibana S, Yamamoto S, Ida M. Percutaneous carpal tunnel release compared with mini-open release using ultrasonographic guidance for both
techniques. The Journal of hand surgery. 2010 Mar;35(3):437-45. Epub 2010/03/03.
45. Rowe NM, Michaels Jt, Soltanian H, Dobryansky M, Peimer CA, Gurtner GC. Sonographically guided percutaneous carpal tunnel release: an anatomic and cadaveric study. Annals of plastic surgery. 2005 Jul;55(1):52-6; discussion 6. Epub
2005/06/30.
46. Lecoq B, Hanouz N, Vielpeau C, Marcelli C. Ultrasound-guided percutaneous surgery for carpal tunnel syndrome: a cadaver study. Joint, bone, spine : revue du rhumatisme. 2011 Oct;78(5):516-8. Epub 2011/02/01.
47. McShane JM, Slaff S, Gold JE, Nazarian LN. Sonographically guided percutaneous needle release of the carpal tunnel for treatment of carpal tunnel syndrome:
preliminary report. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. 2012 Sep;31(9):1341-9. Epub 2012/08/28.
48. Cobb TK, Carmichael SW, Cooney WP. The ulnar neurovascular bundle at the wrist. A technical note on endoscopic carpal tunnel release. Journal of hand surgery
(Edinburgh, Scotland). 1994 Feb;19(1):24-6. Epub 1994/02/01.
49. Gartland JJ. Orthopaedic clinical research. Deficiencies in experimental design and determinations of outcome. The Journal of bone and joint surgery American volume. 1988 Oct;70(9):1357-64. Epub 1988/10/01.
50. Eleftheriou A, Rachiotis G, Varitimidis SE, Koutis C, Malizos KN, Hadjichristodoulou C. Cumulative keyboard strokes: a possible risk factor for carpal tunnel syndrome.
Journal of occupational medicine and toxicology (London, England). 2012 Aug 2;7(1):16. Epub 2012/08/04.
51. McGorry RW, Fallentin N, Andersen JH, Keir PJ, Hansen TB, Pransky G, et al. Effect of grip type, wrist motion, and resistance level on pressures within the carpal tunnel of normal wrists. Journal of orthopaedic research : official publication of the Orthopaedic Research Society. 2014 Apr;32(4):524-30. Epub 2014/01/07.
52. Rempel DM, Keir PJ, Bach JM. Effect of wrist posture on carpal tunnel pressure while typing. Journal of orthopaedic research : official publication of the Orthopaedic
Research Society. 2008 Sep;26(9):1269-73. Epub 2008/04/03.
53. Fung BK, Chan KY, Lam LY, Cheung SY, Choy NK, Chu KW, et al. Study of wrist posture, loading and repetitive motion as risk factors for developing carpal tunnel syndrome. Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand. 2007;12(1):13-8. Epub 2007/07/07.
54. Chern TC, Kuo LC, Shao CJ, Wu TT, Wu KC, Jou IM. Ultrasonographically Guided Percutaneous Carpal Tunnel Release: Early Clinical Experiences and Outcomes.
Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 2015 Dec;31(12):2400-10. Epub 2015/09/24.
55. Jablecki CK, Andary MT, Floeter MK, Miller RG, Quartly CA, Vennix MJ, et al. Practice parameter: Electrodiagnostic studies in carpal tunnel syndrome. Report of the American Association of Electrodiagnostic Medicine, American Academy of Neurology, and the American Academy of Physical Medicine and Rehabilitation. Neurology. 2002 Jun 11;58(11):1589-92. Epub 2002/06/12.
56. McDonagh C, Alexander M, Kane D. The role of ultrasound in the diagnosis and management of carpal tunnel syndrome: a new paradigm. Rheumatology (Oxford, England). 2015 Jan;54(1):9-19. Epub 2014/08/15.
57. Vogelin E, Nuesch E, Juni P, Reichenbach S, Eser P, Ziswiler HR. Sonographic follow-up of patients with carpal tunnel syndrome undergoing surgical or nonsurgical treatment: prospective cohort study. The Journal of hand surgery. 2010 Sep;35(9):1401-9. Epub 2010/09/03.
58. Kim JK, Koh YD, Kim JO, Choi SW. Changes in Clinical Symptoms, Functions, and the Median Nerve Cross-Sectional Area at the Carpal Tunnel Inlet after Open Carpal Tunnel Release. Clinics in orthopedic surgery. 2016 Sep;8(3):298-302. Epub 2016/09/02.
59. Leite JC, Jerosch-Herold C, Song F. A systematic review of the psychometric properties of the Boston Carpal Tunnel Questionnaire. BMC musculoskeletal disorders. 2006 Oct
20;7:78. Epub 2006/10/24.
60. Levine DW, Simmons BP, Koris MJ, Daltroy LH, Hohl GG, Fossel AH, et al. A selfadministered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. The Journal of bone and joint surgery American volume. 1993 Nov;75(11):1585-92. Epub 1993/11/01.
61. Goss BC, Agee JM. Dynamics of intracarpal tunnel pressure in patients with carpal tunnel syndrome. The Journal of hand surgery. 2010 Feb;35(2):197-206. Epub 2009/12/22.
62. Ahn SY, Hong YH, Koh YH, Chung YS, Lee SH, Yang HJ. Pressure measurement in carpal tunnel syndrome : correlation with electrodiagnostic and ultrasonographic findings. Journal of Korean Neurosurgical Society. 2009 Sep;46(3):199-204. Epub 2009/10/22.
63. Lundborg G, Gelberman RH, Minteer-Convery M, Lee YF, Hargens AR. Median nerve compression in the carpal tunnel--functional response to experimentally induced controlled pressure. The Journal of hand surgery. 1982 May;7(3):252-9. Epub 1982/05/01.
64. Okutsu I, Hamanaka I, Tanabe T, Takatori Y, Ninomiya S. Complete endoscopic carpal canal decompression. American journal of orthopedics (Belle Mead, NJ). 1996 May;25 (5):365-8. Epub 1996/05/01.
65. Hobson-Webb LD, Massey JM, Juel VC, Sanders DB. The ultrasonographic wrist-toforearm median nerve area ratio in carpal tunnel syndrome. Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology. 2008 Jun;119(6):1353-7. Epub 2008/04/05.
66. Marschall A, Ficjian A, Stradner MH, Husic R, Zauner D, Seel W, et al. The Value of Median Nerve Sonography as a Predictor for Short- and Long-Term Clinical Outcomes
in Patients with Carpal Tunnel Syndrome: A Prospective Long-Term Follow-Up Study. PloS one. 2016;11(9):e0162288. Epub 2016/09/24.
67. Yesildag A, Kutluhan S, Sengul N, Koyuncuoglu HR, Oyar O, Guler K, et al. The role of ultrasonographic measurements of the median nerve in the diagnosis of carpal tunnel syndrome. Clinical radiology. 2004 Oct;59(10):910-5. Epub 2004/09/29.
68. Manni M, Bisaccia M, Rinonapoli G, Schiavone A, Meccariello L, McCabe SJ, et al. Reliability, Feasibility and Value of Ecography in Clinical-functional Results in Patients Affected by Carpal Tunnel Syndrome: is There a Correlation? Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH. 2017 Mar;25(1):44-8. Epub 2017/05/10.
69. Serafini G, Derchi LE, Quadri P, Martinoli C, Orio O, Cavallo A, et al. High resolution sonography of the flexor tendons in trigger fingers. Journal of ultrasound in
medicine : official journal of the American Institute of Ultrasound in Medicine. 1996 Mar;15(3):213-9. Epub 1996/03/01.
70. Kim HR, Lee SH. Ultrasonographic assessment of clinically diagnosed trigger fingers. Rheumatology international. 2010 Sep;30(11):1455-8. Epub 2009/10/24.
71. Sato J, Ishii Y, Noguchi H, Takeda M. Sonographic appearance of the flexor tendon, volar plate, and A1 pulley with respect to the severity of trigger finger. The Journal of hand surgery. 2012 Oct;37(10):2012-20. Epub 2012/09/04.
72. Chiang CH, Kuo LC, Kuo YL, Wu KC, Shao CJ, Chern TC, et al. The value of highfrequency ultrasonographic imaging for quantifying trigger digits: a correlative study with clinical findings in patients with different severity grading. Ultrasound in medicine & biology. 2013 Jun;39 (6):967-74. Epub 2013/04/09.
73. Yang TH, Lin YH, Chuang BI, Chen HC, Lin WJ, Yang DS, et al. Identification of the Position and Thickness of the First Annular Pulley in Sonographic Images. Ultrasound
in medicine & biology. 2016 May;42(5):1075-83. Epub 2016/02/03.
74. Moore JS. Flexor tendon entrapment of the digits (trigger finger and trigger thumb). Journal of occupational and environmental medicine. 2000 May;42(5):526-45. Epub
2000/05/29.
75. Mifune Y, Inui A, Sakata R, Harada Y, Takase F, Kurosaka M, et al. High-resolution ultrasound in the diagnosis of trigger finger and evaluation of response to steroid injection. Skeletal radiology. 2016 Dec;45 (12):1661-7. Epub 2016/10/21.
76. Kim SJ, Lee CH, Choi WS, Lee BG, Kim JH, Lee KH. The thickness of the A2 pulley and the flexor tendon are related to the severity of trigger finger: results of a prospective study using high-resolution ultrasonography. The Journal of hand surgery, European volume. 2016 Feb;41(2):204-11. Epub 2015/11/17.
77. Chuang XL, Ooi CC, Chin ST, Png MA, Wong SK, Tay SC, et al. What triggers in trigger finger? The flexor tendons at the flexor digitorum superficialis bifurcation. Journal of
plastic, reconstructive & aesthetic surgery : JPRAS. 2017 Oct;70(10):1411-9. Epub 2017/07/16.
78. Miyamoto H, Miura T, Isayama H, Masuzaki R, Koike K, Ohe T. Stiffness of the first annular pulley in normal and trigger fingers. The Journal of hand surgery. 2011 Sep;36(9):1486-91. Epub 2011/08/02.
79. Guerini H, Pessis E, Theumann N, Le Quintrec JS, Campagna R, Chevrot A, et al. Sonographic appearance of trigger fingers. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. 2008 Oct;27(10):1407-13. Epub 2008/09/24.
80. Sato J, Ishii Y, Noguchi H, Takeda M. Sonographic analyses of pulley and flexor tendon in idiopathic trigger finger with interphalangeal joint contracture. Ultrasound in
medicine & biology. 2014 Jun;40(6):1146-53. Epub 2014/03/13.
81. Sato J, Ishii Y, Noguchi H. Comparison of the Thickness of Pulley and Flexor Tendon Between in Neutral and in Flexed Positions of Trigger Finger. The open orthopaedics
journal. 2016;10:36-40. Epub 2016/04/22.
82. Lundin AC, Aspenberg P, Eliasson P. Trigger finger, tendinosis, and intratendinous gene expression. Scandinavian journal of medicine & science in sports. 2014 Apr;24(2):363-8. Epub 2012/08/14.
83. Sbernardori MC, Bandiera P. Histopathology of the A1 pulley in adult trigger fingers. The Journal of hand surgery, European volume. 2007 Oct;32(5):556-9. Epub 2007/10/24.
84. Martinoli C, Bianchi S, Nebiolo M, Derchi LE, Garcia JF. Sonographic evaluation of digital annular pulley tears. Skeletal radiology. 2000 Jul;29(7):387-91. Epub 2000/08/30.
85. Klauser A, Frauscher F, Bodner G, Halpern EJ, Schocke MF, Springer P, et al. Finger pulley injuries in extreme rock climbers: depiction with dynamic US. Radiology. 2002
Mar;222(3):755-61. Epub 2002/02/28.
86. Boutry N, Titecat M, Demondion X, Glaude E, Fontaine C, Cotten A. High-frequency ultrasonographic examination of the finger pulley system. Journal of ultrasound in
medicine : official journal of the American Institute of Ultrasound in Medicine. 2005 Oct;24(10):1333-9. Epub 2005/09/24.
論文全文使用權限
  • 同意授權校內瀏覽/列印電子全文服務,於2021-09-01起公開。
  • 同意授權校外瀏覽/列印電子全文服務,於2021-09-01起公開。


  • 如您有疑問,請聯絡圖書館
    聯絡電話:(06)2757575#65773
    聯絡E-mail:etds@email.ncku.edu.tw