肘管综合征尺神经的前置方式及其疗效比较

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。     

Cubital tunnel syndrome: evaluation of anterior subcutaneous transposition of the ulnar nerve]

57 cases of cubital tunnel syndrome were treated by anterior subcutaneous transposition of the ulnar nerve. Physical examination showed that ulnar nerve function--motor and sensory improved after surgery treatment. Subcutaneous transposition is a reliable and effective surgical option.     

Cubital tunnel syndrome: anterior transposition with epicondylar osteotomy

In this article we reviewed nine consecutive patients operated on for cubital tunnel syndrome. They underwent a modification of the Learmonth procedure in which a medial epicondyle osteotomy was performed. The dissection was completed within intermuscular tissue planes to allow the ulnar nerve to be transposed submuscularly. The medial epicondyle was then replaced and secured using two 4.0 mm AO cancellous screws. This article describes an operative technique, which has not been definitively described previously. Eight of nine patients demonstrated both subjected and objective improvement postoperatively. Eight patients returned to work following surgery. We fell that medial epicondylar osteotomy and screw fixation has minimized operative bleeding, subsequent inflammation, and fibrosis. Immediate range of motion activities have been encouraged, and earlier complete rehabilitation demonstrated.     

Cubital tunnel syndrome caused by ganglion cysts: a review of 59 cases

Acta Neurochirurgica - Cubital tunnel syndrome caused by ganglion cysts is rare and reports are few. This study aimed to review a patient cohort with ganglion cysts in the cubital tunnel and...     

Cubital tunnel syndrome.

Cubital tunnel syndrome is the second most common compressive neuropathy of the upper extremity. Key factors in the history, physical, and differential are outlined to assist the clinician in making an accurate diagnosis. Nonoperative measures and surgical options are reviewed, with medial epicondylectomy being the authors' preferred operative technique.     

Cubital tunnel syndrome: anterior transposition as a logical approach to complete nerve decompression.

In it's native position, deep to Osborne's ligament, within the retrocondylar groove of the elbow, the ulnar nerve courses with a significant lever distance posterior to the elbow axis of rotation. In this position, flexion of the elbow places longitudinal traction and local compression forces on the nerve. This biomechanical consideration, as well as variations in anatomy, may potentially contribute to a decrease in the nerve's microcirculation and partial pressure of oxygen, leading to cubital tunnel syndrome. Anterior transposition of the ulnar nerve at the elbow for cubital tunnel syndrome will eliminate natural as well as pathological traction and compression forces; the procedure relieves the nerve of potential microcirculation compromise. Risks of mobilizing the nerve for transposition, however, include iatrogenic ischemia from segmental separation of the nerve from its mesentery-like extrinsic blood supply. Intrinsic interstitial "step-ladder" vessels within the substance of the ulnar nerve allow it to be separated from its extrinsic circulation safely, making anterior transposition a logical and reasonable choice for cubital tunnel syndrome requiring operative intervention.     

肘管综合征尺神经皮下前置术疗效回顾性分析

目的 :应用术前功能障碍分度和术后疗效分级法 ,评价肘管综合征应用尺神经皮下前置术的疗效及其影响因素。方法 :从 1995～ 2 0 0 3年 ,应用尺神经皮下前置术治疗 3 4例肘管综合征患者。根据Goldberg分度法将肘管综合征分为轻度、中度和重度。疗效参照Lascar分级法 ,分为全部恢复 (优 )、部分恢复 (良 )、无变化 (可 )和恶化 (差 )。同时分析年龄、病程、病因、术中发现对手术预后的影响和感觉障碍、爪形指、第 1背侧骨间肌萎缩、手指内收外展受限等恢复进程 ,并检查肘部切口瘢痕触痛情况。结果 :肘管综合征轻、中度患者 15例 ,疗效优良率为10 0 %。重度 19例 ,疗效优良率为 74%。 3例肘部手术瘢痕有叩击痛。结论 :尺神经皮下前置法是治疗肘管综合征简单可靠的方法。年龄越小、病程越短、症状以感觉障碍为主 ,则术后恢复时间越短、疗效越好     

Cubital tunnel syndrome: results of simple decompression]

32 cases of cubital tunnel syndrome were treated by simple decompression of the ulnar nerve. Physical examination showed that ulnar nerve function - motor and sensory improved after surgery treatment. Simple decompression is a reliable and effective surgical option.     

Cubital tunnel syndrome with olecranic bursitis--report of a case]

This paper describes a case of surgical treatment in 54 years old patient with cubital tunnel syndrome and bursitis olecrani. Simple decompression of the ulnar nerve provided gut satisfaction.     

应用显微外科技术治疗肘管综合征22例分析

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。     

Proximal ulnar nerve compression. Cubital tunnel syndrome.

Ulnar nerve compression about the elbow is common. If diagnosed and treated early, satisfactory results can be expected. Severe chronic nerve compression may lead to permanent nerve damage. The diagnosis can be made by careful history, physical examination, knowledge of the nerve anatomy, and sometimes electrodiagnosis. Cubital tunnel syndrome must be differentiated from TOS and ulnar tunnel syndrome. Double-crush syndrome should be ruled out. Nonoperative treatment must be attempted first, whereas surgical treatment is indicated in severe and chronic cases. Satisfactory results can be achieved after surgery if nerve damage is absent and careful attention to technical details and gentle handling of the nerve are exercised.     

皮下前置术与带血运前置术治疗肘管综合征的疗效对比

目的比较两种治疗肘管综合征手术方法的疗效。方法回顾分析2008年1月-2012年1月收治的160例肘管综合征患者,其中97例接受传统皮下前置术,63例接受带血运前置术。根据手外科尺神经功能评定标准评价两组患者的尺神经功能,然后分别比较两组的评分、中重度患者的优良率及总优良率。结果术后两组的评分分别为（7．5±0．86）分、（7．4±0．96）分,无统计学差异（P〉0．05）。带血管蒂前置组总优良率为87．3％,略高于传统皮下前置组86．59％（P〉0．05）。两组间中度患者的术后优良率分别为88．09％,94．73％（P〉0．05）,但重度患者的优良率分别为85．71％和57．14％（P〈0．05）,有统计学差异（P〈0．05）。结论带血运前置术治疗重度肘管综合征疗效优于传统皮下前置术。     

肘骨性关节炎合并囊肿致肘管综合征1例

<正>患者,男,51岁,左肘间断疼痛10年,左手环、小指麻木、无力半年。病史:患者10年来因双肘部高强度劳动,出现间断疼痛,以劳累后明显,症状逐年加重,并伴有功能障碍,近半年来因左肘部外伤出现左手环、小指感觉麻木、无力,并呈进行性加重,行保守治疗无效,于2009年3月4日前来就诊。查体:体型偏胖,肘关节伸屈活动-10°～120°,左手呈轻度     

Cubital tunnel syndrome and heterotopic ossification. Eight case reports

INTRODUCTION: The occurrence of cubital tunnel syndrome during heterotopic ossification is infrequent. Entrapment of the nerve requires early decompression whereas definitive elbow release is often delayed to reduce the risk of recurrence of periarticular ossification. The pathophysiology and treatment of these two conditions are discussed. METHOD: The authors report a retrospective study of eight men (average age 37 years), all with previous head injury. The nerve entrapment was severe in two cases, moderate in four and mild in two. The elbow was ankylosed with a mean flexion deformity of 96 degrees (77 degrees-123 degrees). Management consisted of early decompression and neurolysis with anterior transposition of the ulnar nerve. In four cases elbow release was postponed until maturation of the ossification. RESULTS: The neurolysis results were assessed according to the score of KLEIMAN modified by TEOH. They were excellent in two cases, good in five and bad in one. DISCUSSION: Entrapment of the ulnar nerve in the context of heterotopic ossification seems related to compression and tension on the ulnar nerve. The compression may be due to prolonged pressure of the medial edge of the elbow on the bed of the nerve, or to a periarticular bony bridge and the initial inflammatory reaction of the heterotopic ossification. Ulnar nerve tension seems to be due to prolonged flexion of the elbow joint and to movements of the shoulder and the wrist, on either side of the ankyrozed elbow. Treatment should be by early decompression of the nerve and we recommend, in addition, anterior transposition to reduce the tension on the nerve. The elbow release can be combined with the neurolysis or delayed according to the state of activity of the heterotopic ossification.     

Medial tarsal tunnel syndrome: a review

The medial tarsal tunnel syndrome is a compression neuropathy involving the tibial nerve or its branches as they pass through the tarsal tunnel under the flexor retinaculum. Medial tarsal tunnel syndrome is not recognized as readily as its counterpart in the wrist. This syndrome can lead to a painful burning sensation in the medial border of the foot and into the great toe. In its fullest extent medial tarsal tunnel syndrome can involve sensory changes in the heel and the lateral part of the sole of the foot as well as the remaining toes. In addition, it may lead to weakness of the intrinsic muscles of the foot. This syndrome often goes unrecognized or misdiagnosed particularly in the athlete. While medial tarsal tunnel syndrome may respond initially to nonoperative techniques of ultrasound and modification of footwear, as it progresses surgical release of the nerve in the tunnel will be required for optimal results. This paper reviews the anatomy, etiology, pathology, clinical presentation, and treatment of the medial tarsal tunnel syndrome. In order to bring more attention to this condition, our clinical experience is presented.J Orthop Sports Phys Ther 1984;6(1):39-45.     

Simple decompression or subcutaneous anterior transposition of the ulnar nerve for cubital tunnel syndrome

The purpose of this prospective randomised study was to evaluate which operative technique for treatment of cubital tunnel syndrome is preferable: subcutaneous anterior transposition or nerve decompression without transposition. This study included 66 patients suffering from pain and/or neurological deficits with clinically and electromyographically proven cubital tunnel syndrome. Thirty-two patients underwent nerve decompression without transposition and 34 underwent subcutaneous transposition of the nerve. Follow-up examinations evaluating pain, motor and sensory deficits as well as motor nerve conduction velocities, were performed 3 and 9 months postoperatively. There were no significant differences between the outcomes of the two groups at either postoperative follow-up examination. We recommend simple decompression of the nerve in cases without deformity of the elbow, as this is the less invasive operative procedure.