Campbell W W, Pridgeon R M, Riaz G, Astruc J, Sahni K S
Department of Neurology, Medical College of Virginia, Richmond.
Muscle Nerve. 1991 Aug;14(8):733-8. doi: 10.1002/mus.880140807.
Two processes account for most instances of ulnar neuropathy at the elbow: compression in the retroepicondylar groove, and compression by the humeroulnar aponeurotic arcade joining the two heads of the flexor carpi ulnaris. While conventional electrodiagnostic criteria may localize an ulnar neuropathy to the elbow, separating retroepicondylar compression from humeroulnar arcade compression is more difficult. In 130 cadaver elbows, we examined the relationships between the medial epicondyle, flexor carpi ulnaris, and ulnar nerve. The humeroulnar arcade lay from 3 to 20 mm distal to the medial epicondyle, the intramuscular course of the nerve through the flexor carpi ulnaris ranged from 18 to 70 mm, and the nerve exited the flexor carpi ulnaris 28 to 69 mm distal to the medial epicondyle. In 6 specimens, dense fibrous bands bridged directly between the medial epicondyle and the olecranon proximal to the cubital tunnel proper; accessory epitrochleoanconeus muscles were present in 14 specimens: both may cause ulnar neuropathy at the elbow. Anatomical variations may contribute to the difficulty in separating causes of ulnar neuropathy at the elbow.
肱骨内上髁后方沟处的压迫，以及连接尺侧腕屈肌两头的肱尺腱膜弓的压迫。虽然传统的电诊断标准可将尺神经病变定位至肘部，但区分肱骨内上髁后方压迫与肱尺腱膜弓压迫更为困难。在130个尸体肘部标本中，我们研究了肱骨内上髁、尺侧腕屈肌和尺神经之间的关系。肱尺腱膜弓位于肱骨内上髁远侧3至20毫米处，神经在尺侧腕屈肌内的走行长度为18至70毫米，神经在肱骨内上髁远侧28至69毫米处穿出尺侧腕屈肌。在6个标本中，致密纤维带直接连接肱骨内上髁与肘管近端的鹰嘴；14个标本存在副肱肌：两者均可导致肘部尺神经病变。解剖变异可能导致区分肘部尺神经病变病因存在困难。
