Campbell W W, Sahni S K, Pridgeon R M, Riaz G, Leshner R T
Department of Neurology, Medical College of Virginia, Richmond 23249.
Muscle Nerve. 1988 Jan;11(1):75-81. doi: 10.1002/mus.880110112.
At the elbow the ulnar nerve may be compressed either in the retrocondylar groove or at the cubital tunnel. Optimal surgical therapy should be directed at the specific site of involvement. Intraoperative electroneurography performed in conjunction with 19 ulnar nerve explorations helped localize the precise site of compression. Of the primary procedures, abnormality was at the retrocondylar groove in 9, cubital tunnel in 4, both locations in 3, and at an unusual distal point in 1; 12 anterior subcutaneous transpositions, 4 cubital tunnel releases, and 1 distal decompression resulted. Intraoperative studies helped identify residual compression in two patients undergoing reexploration. Although routine electrodiagnosis may localize an ulnar neuropathy to the elbow, reliably separating retrocondylar from cubital tunnel compression is more difficult. Preoperatively, percutaneous serial short increment studies were more accurate than simple "inching" in predicting the site of compression.
在肘部，尺神经可能在髁后沟或肘管处受到压迫。最佳的手术治疗应针对具体的受累部位。在19例尺神经探查术中同时进行术中神经电生理检查，有助于定位确切的压迫部位。在初次手术中，9例压迫部位在髁后沟，4例在肘管，3例在两个部位均有压迫，1例在不寻常的远端部位；结果进行了12例前皮下移位术、4例肘管松解术和1例远端减压术。术中研究有助于识别两名再次探查患者的残余压迫。尽管常规电诊断可将尺神经病变定位至肘部，但可靠地区分髁后沟压迫与肘管压迫更为困难。术前，经皮连续短增量研究在预测压迫部位方面比简单的“渐进法”更准确。
