肘管综合征原位松解手术中关于尺神经卡压部位的探讨  

Discussion on the ulnar nerve entrapment site of in situ decompression of cubital tunnel syndrome

作　　者：张政[1] 刘永涛[1] 宋坤修[1] 马丙栋[1] 张岱捷 赵伟[1] ZHANG Zheng;LIU Yongtao;SONG Kunxiu(Department of Hand Surgery,Hospital Affiliated to Binzhou Medical College,Binzhou,256600,China)

机构地区：[1]滨州医学院附属医院手显微外科,山东滨州256600

出　　处：《实用手外科杂志》2020年第3期308-310,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨肘管综合征原位松解手术中尺神经的卡压部位并评估治疗效果。方法2017年1月-2019年1月,采用尺神经原位松解术治疗肘管综合征22例,术前全部经神经肌电图证实,所有病例行尺神经原位松解术,根据术中探查情况,分析尺神经卡压部位。结果术中发现造成肘部尺神经卡压部位中Osborne韧带卡压10例,肘关节腱鞘囊肿卡压7例,被尺侧腕屈肌两头之间腱性组织卡压5例。尺神经功能(主要是感觉)在术后均有显著改善。结论肘管综合征行尺神经原位松解手术中,造成尺神经卡压的部位主要有Osborne韧带、腱鞘囊肿和尺侧腕屈肌两头之间腱性组织。找到尺神经卡压点并予以处理对尺神经原位松解手术的效果至关重要。Objective To review and analyze the entrapment site of ulnar nerve in the surgery of in situ decompression of cubital tunnel syndrome.Methods Between January 2017 and January 2019,22 cases of cubital tunnel syndrome were treated by in situ decompression of ulnar nerve.All patients were confirmed by electromyography before surgery.All patients underwent in situ decompression of ulnar nerve.According to the exploration during surgery,the location of ulnar nerve compression was analyzed.Results Ten cases of Osborne ligament,7 cases of tendinous cyst of elbow joint and 5 cases of tendinous tissue between the two ends of flexor carpi ulnaris muscle were found.The function of ulnar nerve(mainly sensation)improved significantly after surgery.Conclusion In situ decompression of ulnar nerve for cubital tunnel syndrome,the main sites of ulnar nerve compression are Osborne ligament,tendon sheath cyst and tendon tissue between the two ends of ulnar flexor carpi.It is very important to find compression point of ulnar nerve and deal with it for the effect of in situ decompression surgery of ulnar nerve.

关 键 词：肘管综合征 原位松解术 卡压部位 

分 类 号：R688[医药卫生—骨科学]