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腕管综合征中肘管内的静脉包裹对尺神经的影响。

Vein wrapping at cubital tunnel for ulnar nerve problems.

机构信息

Department of Orthopaedic Surgery, Hand & Upper Extremity Surgery, Allegheny General Hospital, Pittsburgh, PA 15212, USA.

出版信息

J Shoulder Elbow Surg. 2010 Mar;19(2 Suppl):91-7. doi: 10.1016/j.jse.2009.12.019.

Abstract

BACKGROUND

Recurrent compression of the ulnar nerve in the cubital tunnel is a difficult problem and many solutions have been tried with variable success. Autologous vein graft wrapping is an alternative technique and it is recommended for the treatment of recalcitrant ulnar nerve compression in which 2 or more previous surgical procedures have failed to resolve the problem.

METHODS

Seventeen patients with recurrent cubital tunnel syndrome were treated with autologous saphenous vein wrapping. These patients had previously undergone simple decompression, decompression combined with medial epicondylectomy, anterior submuscular, or intramuscular transposition with internal neurolysis and had persistence of symptoms. Each patient underwent both subjective and objective evaluation.

RESULTS

Our clinical results on 17 patients have been encouraging. All patients reported significant pain relief, while improvements in grip strength and 2-point discrimination were also observed. There were no complications, other than transient leg swelling secondary to harvesting the saphenous vein graft from the leg.

CONCLUSION

This technique is not technically demanding, has low donor site morbidity, and leads to pain relief and high patient satisfaction.

摘要

背景

尺神经在肘管内反复受压是一个难题,许多解决方案都有不同程度的成功。自体静脉移植包裹是一种替代技术,推荐用于治疗复发性尺神经压迫,即 2 次或 2 次以上手术未能解决问题。

方法

17 例复发性肘管综合征患者采用自体大隐静脉包裹治疗。这些患者之前曾接受过单纯减压、减压联合内上髁切除术、前肌下或肌内移位伴内神经松解术,但症状仍持续存在。每位患者均进行了主观和客观评估。

结果

我们对 17 例患者的临床结果感到鼓舞。所有患者均报告疼痛明显缓解,同时握力和 2 点辨别觉也有所改善。除了从腿部采集大隐静脉移植物后出现短暂的腿部肿胀外,没有其他并发症。

结论

该技术技术要求不高,供区并发症少,可缓解疼痛,提高患者满意度。

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