Palmer Bradley A, Hughes Thomas B
Drexel University College of Medicine, Philadelphia, PA, USA.
J Hand Surg Am. 2010 Jan;35(1):153-63. doi: 10.1016/j.jhsa.2009.11.004.
Cubital tunnel syndrome is the second most common compression neuropathy in the upper extremity. Patients complain of numbness in the ring and small fingers, as well as hand weakness. Advanced disease is complicated by irreversible muscle atrophy and hand contractures. Ulnar nerve decompression can help to alleviate symptoms and prevent more advanced stages of dysfunction. Many surgical treatments exist for the treatment of cubital tunnel syndrome. In situ decompression, transposition of the ulnar nerve into the subcutaneous, intramuscular, or submuscular plane, or medial epicondylectomy have all been shown to be affective in the treatment of this disease process. Comparative studies have shown some short-term advantages to one or another technique, but overall results between the treatments have essentially been equivocal. The choice of surgical treatment is based on multiple factors, and a single surgical approach cannot be applied to all clinical situations. Through careful consideration of the potential sites of nerve compression and the etiologies for these local irritations, the appropriate surgical technique can be selected and a good outcome anticipated in most patients.
肘管综合征是上肢第二常见的压迫性神经病变。患者会抱怨环指和小指麻木，以及手部无力。病情严重时会出现不可逆的肌肉萎缩和手部挛缩等并发症。尺神经减压有助于缓解症状并预防功能障碍进入更严重阶段。治疗肘管综合征有多种手术方法。原位减压、将尺神经移位至皮下、肌内或肌下平面，或内上髁切除术，均已证明对治疗此疾病有效。比较研究显示，不同技术有一些短期优势，但总体治疗效果基本相当。手术治疗的选择基于多种因素，单一手术方法无法适用于所有临床情况。通过仔细考虑神经受压的潜在部位以及这些局部刺激的病因，可以选择合适的手术技术，并预期大多数患者能取得良好疗效。
