Sunagawa Toru, Nakashima Yuko, Shinomiya Rikuo, Kurumadani Hiroshi, Adachi Nobuo, Ochi Mitsuo
Department of Orthopedic Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Hiroshima, 734-8551, Japan.
Laboratory of Analysis and Control of Upper Extremity Function, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Muscle Nerve. 2017 Apr;55(4):508-512. doi: 10.1002/mus.25361. Epub 2016 Dec 23.
In recent operative cases of anterior interosseous nerve palsy (AINP), hourglass-like fascicular constrictions have been reported. We prospectively investigated the ultrasonographic history of these lesions to better understand the role of this lesion in AINP.
Seven patients who were diagnosed with idiopathic AINP based on classic clinical findings and had hourglass-like fascicular constrictions found on ultrasonography were included. All but 1 patient selected surgery, and we followed up all patients clinically and with ultrasonography.
In the 5 patients treated surgically in whom paralysis recovered to a level greater than M4, postoperative ultrasonography revealed less constriction. The other patient experienced little recovery after surgery, and the severe constriction remained. In a conservatively treated patient, the paralysis recovered completely, and upon ultrasonography, the constriction had lessened.
Although the mechanism is still unknown, hourglass-like fascicular constriction lessened with relief of motor weakness both in operatively and conservatively treated patients. Muscle Nerve 55: 508-512, 2017.
在近期的骨间前神经麻痹（AINP）手术病例中，有沙漏样束状狭窄的报道。我们对这些病变的超声检查情况进行了前瞻性研究，以更好地了解该病变在AINP中的作用。
纳入7例根据典型临床表现诊断为特发性AINP且超声检查发现有沙漏样束状狭窄的患者。除1例患者外，其余患者均选择手术治疗，我们对所有患者进行了临床及超声随访。
在5例接受手术治疗且麻痹恢复至大于M4水平的患者中，术后超声显示狭窄减轻。另1例患者术后恢复甚微，严重狭窄依然存在。1例保守治疗的患者麻痹完全恢复，超声检查显示狭窄减轻。
尽管机制尚不清楚，但无论是手术治疗还是保守治疗的患者，随着运动无力的缓解，沙漏样束状狭窄均减轻。《肌肉与神经》55: 508 - 512, 2017年。
