Dell Paul C, Sforzo Christopher R
Department of Orthopaedics, University of Florida Medical Center, Gainesville 32611-2727, USA.
J Hand Ther. 2005 Apr-Jun;18(2):198-207. doi: 10.1197/j.jht.2005.02.008.
Normal hand function is a balance between the extrinsic and intrinsic musculature. Although individually the intrinsics are small muscles in diameter, collectively they represent a large muscle that contributes approximately 50% of grip strength. Dysfunction of the intrinsics consequently leads to impaired grip and pinch strength as well recognized deformities. Low ulnar nerve palsy preserves ulnar innervated extrinsics resulting in sensory loss, digital clawing, thumb deformity, abduction of the small finger, and asynchronous finger motion. High ulnar nerve palsy is characterized by the above plus paralysis of the ulnar profundi and the flexor carpi ulnaris. Understanding the normal anatomy allows the clinician to identify the site of the lesion and plan appropriate surgical intervention. This article revisits the classic work of Richard J. Smith on ulnar nerve palsy with contemporary perspective.
正常手部功能是外在肌和内在肌之间的平衡。虽然内在肌个体直径较小，但总体上它们构成了一块大肌肉，约占握力的50%。因此，内在肌功能障碍会导致握力和捏力受损以及公认的畸形。尺神经低位麻痹会保留由尺神经支配的外在肌，导致感觉丧失、手指爪形畸形、拇指畸形、小指外展和手指运动不同步。尺神经高位麻痹的特征是上述症状加上尺侧深肌和尺侧腕屈肌麻痹。了解正常解剖结构有助于临床医生确定病变部位并规划适当的手术干预。本文从当代视角重温了理查德·J·史密斯关于尺神经麻痹的经典著作。
