Dickerman Rob D, Stevens Qualls E J, Cohen Anders J, Jaikumar S
Surgical Neurology Branch, National Institutes of Neurological Disease and Stroke, National Institutes of Health, Bethesda, Maryland, USA.
J Peripher Nerv Syst. 2002 Dec;7(4):229-32. doi: 10.1046/j.1529-8027.2002.02030.x.
Radial tunnel syndrome (RTS) is thought to result from intermittent and dynamic compression of the posterior interosseous nerve (PIN) in the proximal part of the forearm associated with repeated supination and pronation. The diagnostic criteria encompassing RTS are purely clinical and the term "radial tunnel syndrome" has become controversial because of the lack of focal motor weakness in the majority of patients diagnosed with RTS. Retrospective cadaveric and surgical studies have revealed several areas within the forearm in which the PIN may become entrapped. Recent studies have suggested that the PIN is "fixed" in the supinator muscle and that wrist pronation is the actual movement that places the most stress on the PIN. The patients most often afflicted with RTS appear to be those who perform repetitive manual tasks involving rotation of the forearm and athletes involved in racket sports. Surgical exploration with decompression of the PIN is often required in patients with RTS. We present the first case of RTS occurring in an elite power athlete and believe this case represents a direct compressive sensory neuropathy. The optimum nonsurgical treatment plan for the elite athlete in training for competition and the cause of this compressive neuropathy in power athletes will be discussed.
桡管综合征（RTS）被认为是由于在前臂近端，骨间后神经（PIN）受到间歇性和动态性压迫，与反复旋前和旋后相关。涵盖RTS的诊断标准完全基于临床，并且“桡管综合征”这一术语已颇具争议，因为大多数被诊断为RTS的患者缺乏局灶性运动无力。回顾性尸体研究和手术研究揭示了前臂内PIN可能被卡压的几个部位。最近的研究表明，PIN在旋后肌中是“固定的”，并且手腕旋前是对PIN施加最大压力的实际动作。最常患RTS的患者似乎是那些进行涉及前臂旋转的重复性手工任务的人以及从事球拍运动的运动员。RTS患者通常需要进行手术探查并对PIN进行减压。我们报告了第一例发生在精英力量型运动员身上的RTS病例，并认为该病例代表了一种直接压迫性感觉神经病变。将讨论针对正在为比赛进行训练的精英运动员的最佳非手术治疗方案以及力量型运动员中这种压迫性神经病变的病因。
