Konczak Clark R
Post-graduate student, The Chiropractic Unit, Department of Complementary Medicine, RMIT University.
J Can Chiropr Assoc. 2005 Mar;49(1):40-5.
A case is presented that illustrates and discusses the clinical presentation, diagnosis and chiropractic management of a 50-year-old male presenting with a case of ulnar neuropraxia following extracorporal shockwave lithotripsy. Onset is believed to be due to the patient's arm position in full abduction and external rotation during the lithotripsy procedure. Motor abnormalities related to the ulnar nerve were noted in the absence of distinct sensory findings. Chiropractic treatment focused on relief of the patient's pain during the course of the condition. Treatment may have helped in the rapid and complete resolution of his symptoms in this case. Poor patient positioning on hard surfaces, for extended periods may place pressure on superficial nerves resulting in nerve injury. In this case, the outcome was excellent, with complete resolution of symptoms less than one week later. The prognosis for this type of neuropraxia is usually good with conservative management. The patient history and chronological clinical course strongly suggest a causal association between the patient's position during the procedure and the development of the ulnar neuropraxia.
本文介绍并讨论了一例50岁男性患者的临床病例，该患者在体外冲击波碎石术后出现尺神经失用症。据信发病原因是在碎石手术过程中患者手臂处于完全外展和外旋位置。在没有明显感觉异常的情况下，发现了与尺神经相关的运动异常。整脊治疗的重点是在病情发展过程中缓解患者的疼痛。在本病例中，治疗可能有助于患者症状迅速完全缓解。长时间在坚硬表面上患者体位不当可能会压迫浅表神经，导致神经损伤。在本病例中，结果非常理想，不到一周后症状就完全消失了。这种类型的神经失用症采用保守治疗，预后通常良好。患者病史和按时间顺序记录的临床病程强烈提示手术过程中患者的体位与尺神经失用症的发生之间存在因果关系。
