共查询到20条相似文献,搜索用时 468 毫秒
1.
2.
带血管蒂尺神经松解前置治疗肘管综合征 总被引:1,自引:1,他引:0
目的 初步探讨带血管蒂尺神经松解前置治疗肘管综合征的疗效.方法 总结分析79例带血管蒂尺神经松解前置术治疗肘管综合征患者,采用肘管切开带血管蒂尺神经松解皮下前置35例、深部前置(带血管蒂肌下前置术:带血管蒂肌内前置术)治疗肘管综合征44例.结果 随访6个月~8年,平均随访3.5年.疗效按Macnicol肘管综合征术后客观判断标准评定,带血管蒂尺神经松解皮下前置术者35例,优8例,良12例,可11例,差4例;带血管蒂尺神经松解深部前置44例,优14例,良11例,可15例,差3例.结论 应用显微外科技术行带血管蒂尺神经松解前置治疗肘管综合征的效果确切,在手术显微镜下操作可有效的保护神经外膜伴行的营养血管,长期疗效满意. 相似文献
3.
4.
5.
肘管综合征尺神经的前置方式及其疗效比较 总被引:3,自引:0,他引:3
目的分析比较两种尺神经前置方式治疗肘管综合征的疗效。方法回顾分析45例肘管综合征病例,分别采用尺神经皮下前置和肌下前置两种不同手术方式;获得随访31例,其中行皮下前置23例,肌下前置8例。结果术后随访6个月-8年,平均2.4年。23例皮下前置者疗效优8例,良11例,可3例,差1例,优良率82.6%;8例肌下前置者疗效优2例,良4例,可1例,差1例,优良率75%。尺神经皮下前置和肌下前置的效果没有显著差异,但肘管综合征中度患者的疗效明显好于重度患者。结论肘管综合征的治疗最重要的是对肘管和尺神经彻底的减压,皮下前置和肌下前置两种手术方式的效果没有差异。肘管综合征一旦明确诊断,应积极行手术治疗。 相似文献
6.
7.
目的 评价应用显微外科手术治疗肘管综合征的临床疗效. 方法 从2005年10月至2010年12月,对肘管综合征43例应用显微外科手术治疗.均采用尺神经松解,其中37例行尺神经皮下前置,术后辅以神经营养药物等治疗.结果 术后随访时间为6个月~5年,平均3.2年.按中华医学会手外科学会上肢部分功能评定试用标准评定,结果属优31例,良7例,可3例,差2例,优良率为88.4%. 结论 应用显微外科手术行尺神经松解皮下前置治疗肘管综合征较简便易行,在手术显微镜下操作可有效的彻底松解神经,并使神经的血供不受影响,临床疗效满意. 相似文献
8.
应用显微外科技术治疗肘管综合征22例分析 总被引:1,自引:1,他引:0
目的应用显微外科技术行尺神经松解治疗肘管综合征的疗效分析。方法镜下神经松解解除神经内外瘢痕对神经的压迫,并保护神经束间交通支及营养血管,恢复神经传导功能。结果本组22例,优14例,良6例,差2例。优良率90.9%。结论应用显微外科技术无损伤操作使尺神经松解彻底而适度,疗效确切,是治疗肘管综合征的行之有效的方法。 相似文献
9.
尺神经肌下前置术治疗尺神经延迟麻痹谈志秋,邵维城,秦世杰,王毛顺尺神经肌下前置术是在尺神经前置术的同时,加作肱骨内上踝屈腕肌群起点松解,以此治疗尺神经延迟麻痹,可使尺神经嵌压得以松解;屈腕肌群亦得以松解。用本法治疗,具有比尺神经皮下前置术有更好的疗效... 相似文献
10.
11.
目的 评价肌电图辅助定位小切口尺神经松解术治疗肘管综合征的疗效及手术适应证.方法 选取无明显手内在肌萎缩及肘关节畸形,具有典型临床症状和体征的肘管综合征患者12例,术前通过神经短节段传导(short-segment nerve conduction test,SSCT)检测的方法,以相邻两次动作电位波幅下降>50%或潜伏期差>0.5ms为定位标准,对上述患者进行卡压点定位,采用小切口局部尺神经松解术式,并观察卡压点术中与术前定位比较.结果 术中观测结果证明尺神经损害部位位于肱骨内上髁上方3 cm到肱骨内上髁下方1cm之间,与术前SSCT法检测卡压部位相符.12例术后均主诉手部有明显轻松感;术后3个月感觉异常全部恢复,刺痛觉及爪形指恢复,捏力和抓握力恢复;术后6个月时小指展肌肌力已完全恢复至正常,两点分辨觉平均为5.0 mm,神经传导速度(NCV)均>45.0 m/s,波幅开始增加,SSCT无阳性发现;术后1年肌肉萎缩基本恢复,屈肘试验、肘部Tinel征、夹纸试验阴性,7例肌电图无阳性发现,1例NCV仍低于正常标准,但无临床症状及体征.术中观察神经卡压位置与术前肌电图定位相符.结论 肌电图辅助定位小切口尺神经松解术治疗肘管综合征是一种有效的方法.Abstract: Objective To evaluate the therapeutic effect of in situ ulnar nerve decompression at the cubital tunnel via a small incision assisted with electromyography localization and discuss the surgical indications.Methods Twelve patients who were diagnosed with idiopathic cubital tunnel syndrome (CuTS) without intrinsic muscle atrophy and elbow deformity were involved in the study.Before the operation, short-segment nerve conduction test (SSCT) was carried out.The exact compression site was determined by the > 50%reduction in amplitude or > 0.5 ms lengthening in latency of action potentials recorded upon stimulation of the ulnar nerve around the elbow at 1 cm intervals.An in situ ulnar nerve release at the compression site was performed.Compression of the ulnar nerve was observed and documented to verify the accuracy of pre-operative SSCT localization.Results Intraoperative findings confirmed that lesions were located from 3 cm above to 1 cm below the medial epicondyle, which coincided with the compression sites determined by SSCT.All the patients reported alleviation of hand discomfort postoperatively.Follow-up at 3 months postoperatively showed that paresthesia in the distribution of the ulnar nerve in the hand disappeared.Pinprick sensation recovered.There was no subjective or measurable weakness in pinch or grip strength and no clumsiness or loss of coordination.Claw deformity disappeared.Six months after the surgery, the strength of abductor digiti minimi returned to normal.Two-point discrimination of the little finger was 5.0 mm on average.Nerve conduction velocity returned to > 45.0 m/s.Action potential amplitude increased and SSCT yielded no positive findings.Mild atrophy was reversed one year postoperatively.Elbow flexion test, Tinel' s sign and Froment' s test were all negative.Conclusion In situ ulnar nerve decompression via a small incision assisted with electromyography localization is a suitable procedure for certain CuTS cases. 相似文献
12.
Compression of the deep branch of the ulnar nerve distal to the pisohamate hiatus is rare. Two cases of compression of the deep branch at the adductor hiatus are presented. These cases are unique because of pain in the hand without muscle atrophy. One patient has had surgical treatment, and the other patient's symptoms are not severe enough to warrant surgical treatment. 相似文献
13.
The authors report a case of anomaly of the flexor digiti minimi muscle, which extended into the forearm to be inserted 10 centimetres proximal to the carpal flexion crease on flexor carpi radialis. This anomaly was responsible for ulnar nerve compression when grasping objects with the hand. Cases of ulnar nerve compression at the wrist appear to be rare and the great majority of cases are secondary. Anatomical variants of muscles and nerves at the wrist are not exceptional, hence the importance of systematically looking for such anomalies in patients with ulnar nerve compression at the wrist. Excision of the muscle anomaly eliminated nerve compression and the associated symptoms. 相似文献
14.
《Acta orthopaedica》2013,84(6):728-738
We present an uncommon case of large nonarticular chondromatosis of the hand. Some of the foci were found to cause compression of the median nerve, the ulnar artery, and also triggering of the third finger. The fourth lumbrical muscle was involved as well. A thorough, but not complete, excision with preservation of the median nerve and ulnar artery was performed. No recurrence was found during 5 years of follow-up. 相似文献
15.
We describe the acute development of ulnar nerve compression following carpal tunnel release in a patient with an accessory palmaris longus muscle. Although anomalous muscles in the wrist are relatively common and may produce ulnar nerve compression, this particular occurrence following carpal tunnel release has not been previously described in the literature. We theorize that the compression of the ulnar nerve proximal to Guyon's canal was caused by increased tension along the long axis of the anomalous accessory palmaris longus muscle as a consequence of transverse carpal ligament division. 相似文献
16.
A case of ulnar nerve compression at the wrist caused by a reversed palmaris longus muscle is reported. We are not aware of any previous reports of ulnar nerve compression due to this particular muscle anomaly. 相似文献
17.
K Ishikawa M Kondo K Vainio H P?ti?l? M Lehtimaki P Raunio 《Archives of orthopaedic and traumatic surgery. Archiv für orthop?dische und Unfall-Chirurgie》1987,106(5):309-313
One hundred and twenty definite or classical rheumatoid arthritis (RA) patients with an average duration of the disease of 12.1 years were studied. Sixty-two patients had distinct atrophy of the first dorsal interosseous of the hand without definite signs of carpal, cubital, or ulnar tunnel syndrome (group A); 43 patients showed neither distinct atrophy nor sensory disturbance of either hand (group B). Other patients had sensory and/or motor disturbances due to carpal, cubital, or ulnar tunnel syndrome and other neuropathies. Electrodiagnostic examinations revealed that there were differences in the distal latency to the first dorsal interosseous muscle from the wrist between 24 group-A patients and 14 normal controls (P less than 0.05), and between the group-A patients and 12 group-B patients (P less than 0.1). The results of this study indicate that some RA patients with atrophy of the thumb web space may have compression neuropathy of the most distal branches of the ulnar nerve. 相似文献
18.
Twenty-five brain-injured adults who were treated for tardy ulnar neuropathy during a 5-year period were studied. Two patients had bilateral involvement. The incidence of late ulnar neuropathy in this population was determined to be 2.5%. The ulnar neuropathy was always on the neurologically impaired side and associated with significant spasticity. Diagnosis was made when intrinsic atrophy was noted in the hand. No patient initiated a subjective complaint. Nerve conduction velocity measurements confirmed impingement of the ulnar nerve in the cubital canal in 16 cases. Twenty-one of the 27 (78%) elbows had moderate to severe heterotopic ossification causing impingement of the ulnar nerve. All patients were treated by anterior transposition of the ulnar nerve. Follow-up averaged 22.7 months. Twenty-three (85%) extremities had complete recovery of ulnar nerve function. Four patients had improved but incomplete recovery of function. Prolonged compression of the nerve led to incomplete recovery. 相似文献
19.
Ulnar nerve decompression at the cubital tunnel. 总被引:2,自引:0,他引:2
P R Manske R Johnston D L Pruitt W B Strecker 《Clinical orthopaedics and related research》1992,(274):231-237
A limited surgical decompression of the ulnar nerve within the cubital tunnel by incision of the arcuate ligament was effective in relieving pain and dysesthesia in 22 of 27 patients. No patient had any apparent muscle weakness or atrophy preoperatively. Twenty-five patients had evidence of compression of the ulnar nerve within the cubital tunnel at surgery, as noted by narrowing, hyperemia, or attachment of adhesions to the nerve. Three of four patients who had a subsequent anterior transposition obtained partial relief of symptoms. 相似文献