González G, Mackinnon S E, Espinosa A, Barbour J
Acta Ortop Mex. 2012 Nov-Dec;26(6):375-8.
Neuropathy due to ulnar nerve compression at the elbow level is the second most frequent neuropathy. The scratch collapse test is useful to diagnose compression neuropathies. This test helps us rank compression sites and decide the type of treatment to use.
From May to July 2011, 34 patients, mostly females, were preoperatively analyzed with this test. Ethyl chloride was also used to show other compression sites.
The main compression site was found to be at the level of Osborne's ligament, contrary to the idea that it was located at the medial epicondyle. Another finding was that at the hand and wrist level it is more common to find compression in the proximal fascia of the forearm than in Guyon's canal. After surgery, CRP became negative in all patients.
When the primary collapse point is Osborne's ligament, the patient will require ulnar nerve transposition. When the primary collapse point is located at the level of the medial epicondyle, decompression is enough. In case of several simultaneous collapse points before applying ethyl chloride, a surgical procedure will not necessarily be required for each one of them.
肘部尺神经受压所致的神经病变是第二常见的神经病变。划痕塌陷试验有助于诊断压迫性神经病变。该试验有助于我们对压迫部位进行排序并确定治疗方式。
2011年5月至7月，对34例患者（大多数为女性）进行了术前该试验分析。还使用了氯乙烷来显示其他压迫部位。
主要压迫部位发现位于奥斯本韧带水平，这与认为其位于内上髁的观点相反。另一个发现是，在手部和腕部水平，在前臂近端筋膜处发现压迫比在Guyon管更常见。手术后，所有患者的C反应蛋白均转为阴性。
当主要塌陷点为奥斯本韧带时，患者需要进行尺神经移位。当主要塌陷点位于内上髁水平时，减压就足够了。如果在应用氯乙烷之前有几个同时出现的塌陷点，不一定对每个塌陷点都需要进行手术。
