Sha Ke, Chen Desong, Wei Huangdu, Peng Feng, Fang Yousheng, Wang Tianbing
Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China.
Zhonghua Wai Ke Za Zhi. 2002 Mar;40(3):210-3.
To investigate anatomical mechanism of the ulnar wrist pain caused by the compression of the dorsal branch of the ulnar nerve, and discuss the diagnosis and treatment of the compression.
40 sides of the upper extremities of adult cadavers were studied anatomically. The dorsal branch of the ulnar nerve and its relationship to the surroundings was dissected and observed grossly and microscopically. 13 cases of the compression of the dorsal branch of the ulnar nerve were treated and followed up.
The dorsal branch of the ulnar nerve was penetrated from the deep of the flexor carpi ulnaris muscle 5.6 approximately 6.8 cm proximally from the styloid process of the ulna, then ran along the ulna and divided into 2 approximately 3 big branches at the medial side of the head of the ulna. The transverse branch was apt to injury during wrist movement as it crossed or rounded the head of the ulna where it was close to the peristeam. Seven of 13 cases of the compression of the dorsal branch of the ulnar nerve were treated by local block, and 6 by surgical neurolysis. Nine cases of this group got showed good effect without recurrence after 4 months to 1 year follow-up.
The anatomical basis of the compression of the dorsal branch of the ulnar nerve is repetitive traction to this nerve during wrist movement, and the compression of the transverse branch is the main cause of ulnar wrist pain. The compression of the dorsal branch of the ulnar nerve should be considered to the patients with ulnar wrist pain and abnormal sensation along the dorsal ulnar side of hand.
探讨尺神经背支卡压致尺侧腕部疼痛的解剖学机制，并对其诊断与治疗进行探讨。
对40侧成人尸体上肢进行解剖学研究。对尺神经背支及其周围关系进行大体及显微镜下解剖观察。对13例尺神经背支卡压患者进行治疗及随访。
尺神经背支于尺骨茎突近端约5.6至6.8 cm处从尺侧腕屈肌深面穿出，沿尺骨走行，在尺骨头内侧分为2至3支较大分支。横行分支在腕关节活动时，于绕过或跨越靠近骨膜的尺骨头处易受损伤。13例尺神经背支卡压患者中，7例行局部阻滞治疗，6例行手术神经松解术。该组9例患者经4个月至1年随访，效果良好，无复发。
尺神经背支卡压的解剖学基础是腕关节活动时该神经受到反复牵拉，横行分支受压是尺侧腕部疼痛的主要原因。对于尺侧腕部疼痛且手背尺侧感觉异常的患者，应考虑尺神经背支卡压。
