单纯钩骨钩骨折致尺神经深支损伤的临床研究  

Experience of treating injury of deep branch of ulnar nerve caused by simple hamate hook fractures

作　　者：王斌[1] 李浩[2] 杨焕友[1] 赵刚[1] 

机构地区：[1]河北省唐山市第二医院手一科(河北联合大学附属骨科医院),063000 [2]山东省聊城市人民医院创伤骨科

出　　处：《中国骨与关节损伤杂志》2012年第7期598-600,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨单纯钩骨钩骨折致尺神经深支损伤的致病机理。方法采用16侧甲醛固定和4侧新鲜成人尸体标本。以钩骨钩中点为O，过0点作一条水平线及垂线，水平线与尺神经深支的交点为A点，与钩骨钩基底尺侧交点为B点，垂线与尺神经的交点为C点，分别测量OA、OB、OC、AB长度。并进行统计学分析：对1996年4月-2009年6月5例单纯钩骨钩骨折合并尺神经深支损伤进行回顾分析。结果尺神经深支绕过钩骨钩的基底部进入掌深间隙。OA的长度为（4．96±0．11）mm、OB的长度（3．69±0．12）mm、OC的长度（10．55±1．07）mm、AB的长度为（1．27±0．15）mm；5例根据中华医学会手外科学会上肢周围神经功能评定试用标准：优4例，良1例。结论单纯钩骨钩骨折可致尺神经深支损伤但临床容易漏诊，早期正确诊治是神经功能得以恢复的关键。Objective To discuss the diagnosis and treatment of injury of the deep branch of ulnar nerve, which is caused by ＇the simple fracture of the hook of hamate. Methods The study was done on 16 specimens of formalin-fixed limbs and 4 specimens of fresh adult human cadavers. The midpoint of the hook of haraate bone was defined as dot O, and over O point drew a horizontal and a vertical line. Point A was defined as the intersection point of the horizontal line and the deep branch of ulnar nerve. Point B was defined as the intersection point of the horizontal line and innermost side of the basal part of the hook of hamate bone. Point C was defined as the intersection point of the vertical line and ulnar nerve. Then, the length of OA, OB, OC and AB was measured and analyzed respectively. Five cases of simple fracture of the hook of hamate combined with deep branch of ulnar nerve injury were analyzed retrospectively from April 1996 to June 2009. Results The deep branch of ulnar nerve enters palm deep space bypassing the basal part of the hook of hamate bone.The length of OA,OB,OC and AB was （4.96±0.11）mm, （3.69±0.12）mm,（10.55±1.07）mm,and （1.27±0.15）mm respectively. According to upper limb peripheral nerve function evaluation standards of hand surgery of the Chinese Medical Association Society, four cases were excellent and one case was good among the five cases.Conclusion The simple fracture of the hook of hamate can cause injury to the deep branch of ulnar nerve and may be misdiagnosed. Early diagnosis and treatments of the fracture of the hook of hamate and injury to the deep branch of ulnar nerve is the key to recover nerve functions.

关 键 词：钩骨钩 尺神经深支 创伤和损伤 

分 类 号：R322.85[医药卫生—人体解剖和组织胚胎学]