Gervasio Olga, Zaccone Claudio
Department of Neurosurgery, Bianchi-Melacrino-Morelli Hospital, Reggio Calabria, Italy.
Neurosurgery. 2008 Mar;62(3 Suppl 1):186-92; discussion 192-3. doi: 10.1227/01.neu.0000317392.29551.aa.
We sought to describe the operative technique in ulnar nerve compression caused by the epitrochleoanconeus muscle and a prominent medial head of the triceps. These anatomic features make the approach to the ulnar nerve at the elbow peculiar and may create technical difficulties during surgical treatment of this area.
We reviewed patients who underwent surgery for cubital tunnel syndrome between November 1997 and December 2004. The presence of the epitrochleoanconeus muscle with prominent medial head of the triceps occurred in 3.2% of patients. A detailed and illustrated description of the surgical anatomy and the peculiarities of the surgical approach are provided.
Epitrochleoanconeus muscle and the prominent portion of the medial head of the triceps were sectioned and removed, and simple decompression of the ulnar nerve was performed. This treatment achieved complete recovery in all of the patients affected by moderate-grade syndrome (Dellon Grade 2 syndrome) who had not shown severe-grade syndrome preoperatively.
The simple decompression of the ulnar nerve with myotomy or removal of epitrochleoanconeus muscle and the prominent portion of the medial head of the triceps achieved good postoperative results. Experiences from the literature and alternative surgical options are reported.
我们试图描述由肱三头肌内侧头和肱肌导致尺神经受压的手术技术。这些解剖特征使得在肘部处理尺神经的方法较为特殊，并且在该区域的手术治疗过程中可能会产生技术难题。
我们回顾了1997年11月至2004年12月期间接受肘管综合征手术的患者。肱三头肌内侧头和肱肌在3.2%的患者中出现。本文提供了手术解剖结构及手术入路特点的详细且配有插图的描述。
将肱三头肌内侧头和肱肌的突出部分切断并切除，对尺神经进行简单减压。这种治疗方法使所有术前未表现出重度综合征的中度综合征（德龙2级综合征）患者完全康复。
通过肌切开术或切除肱三头肌内侧头和肱肌的突出部分对尺神经进行简单减压，术后效果良好。文中报告了来自文献的经验及其他手术选择。
