程序化操作在尺神经皮下前置术中的应用

目的 探讨程序化手术操作在尺神经皮下前置术中的应用效果.方法 我院自2017年1月至2019年12月采用尺神经松解皮下前置术治疗肘管综合征病人34例.所有病人均采用程序化操作处理前臂内侧皮神经、Struthers弓、内侧肌间隔、Osborne韧带、尺侧腕屈肌两头、指浅屈肌筋膜、尺神经伴行血管、尺侧屈腕肌肌支及关节支、屈...     

Anterior Transposition of the Ulnar Nerve

Twenty-four patients with 26 ulnar neuropathies in the elbow region were treated by anterior transposition of the ulnar nerve. the dominant arm was involved in 14 of these patients.

Improvement of paresthesia was found in 17 out of 21 (75 per cent) in this series of patients; 10 out of 18 (55 per cent) had improvement of sensation; 7 out of 14 (50 per cent) had less pain; 10 out of 14 (71 per cent) showed an increase in motor power, but only 2 out of 12 patients (16 per cent) with long—standing muscle atrophy showed any improvement in their condition.

Electromyographic studies (EMG) were carried out before and after operation. the postoperative studies revealed increased motor conduction velocity within the elbow segment of the ulnar nerve in 15 patients. Slowing in ulnar nerve conduction velocity was found in 3 patients, and in 8 the EMG remained unchanged.

Our EMG series indicated that patients with a conduction velocity of less than 40 m/s will certainly benefit more from anterior transposition of the ulnar nerve than will patients whose measurements are within the normal range.     

带筋膜尺神经前移治疗肘管综合征

目的 研究带筋膜尺神经前移在肘管综合征治疗中的应用。方法 采用带筋膜的尺神经多术治疗４０例肘管综合征。结果 感觉运动评分提高了３９．２％,有效率达９１．８％。结论带筋膜尺神经前移治疗肘管综合征有助于保护尺神经的血供及神经分支。慢性肘部牵拉伤是导致肘管综合征的主要因素。     

Ulnar nerve pathology at the elbow: the place of anterior transposition today

Summary A retrospective study is presented of 39 patients with ulnar nerve pathology at the elbow. All patients were treated by anterior transposition. Improvement to at least good functional recovery occurred in 46% of the patients. In the other 54% there was only slight or no improvement, or even deterioration. A further analysis of the results showed that in patients with objective signs of ulnar pathology, but without muscular atrophy, the results were good: 64% of these patients showed a good operative result. The most important factors in postoperative prognosis in the patients studied are the existence of muscular atrophy, age, and, in the moderately severe group, the length of history before operation. The aetiology was not important with respect to the outcome. On the basis of the recent literature and the results of this study suggestions are presented for a rational choice between the different possibilities of treatment for ulnar nerve pathology at the elbow.     

尺神经肌下前置术治疗肘管综合征

目的 探讨尺神经松解加肌下前置术治疗肘管综合征的有效性。方法 观测２０例成人尸体上肢标本及３２例患者尺神经移置前后的解剖变化,临床应用３２例。结果 尺侧上副动脉可与尺神经一前置;皮下前置伸肘位时尺神经易受牵拉,肌下前置伸、屈肘时均不受牵拉;新肘管可充分容纳尺神经。３２例中获完整随访２６例。随访期１～３年,１６例（６１．５％）恢复正常。结论 尺神经松解加肌下前置术为治疗肘管综合征较佳术式。     

肘部尺神经卡压与尺神经半脱位的诊疗进展

肘部尺神经卡压也称为肘管综合征,可造成手部一系列功能障碍,是最常见的上肢神经卡压症之一。尺神经脱位及半脱位为尺神经卡压的影响因素。尺神经卡压按McGowan分级分为Ⅰ、Ⅱ、Ⅲ级。Ⅰ级首选保守治疗 Ⅱ、Ⅲ级保守治疗效果欠佳,多需要手术治疗。手术方式主要有尺神经原位松解术（包括肱骨内髁切除术）、粘膜下尺神经前置术、肌下尺神经前置术及肌内尺神经前置术等,其中原位松解手术操作相对简单,但对于尺神经卡压伴有尺神经脱位者多属禁忌,应首选尺神经前置术。