Spies C K, Löw S, Langer M F, Hohendorff B, Müller L P, Unglaub F
Handchirurgie, Vulpius Klinik, Vulpiusstr. 29, 74906, Bad Rappenau, Deutschland.
Klinik für Orthopädie und Unfallchirurgie, Caritas-Krankenhaus, Bad Mergentheim, Deutschland.
Orthopade. 2017 Aug;46(8):717-726. doi: 10.1007/s00132-017-3453-z.
Cubital tunnel syndrome is the second most common nerve compression syndrome observed in the upper extremity. Mechanical irritation of the ulnar nerve is also found in the upper and the lower arm even though cubital tunnel syndrome is documented most of the time. Apart from clinical examination electrophysiological testing is the most important contributor to the therapy decision. Depending on the clinical manifestation conservative treatment with elbow splinting may be appropriate. In the event of persistent or advanced nerve irritation surgical decompression may be the sensible intervention. Open or endoscopically assisted in situ decompression is currently recommended as the primary intervention while anterior transposition of the ulnar nerve is recommended for revision surgery.
肘管综合征是上肢中第二常见的神经卡压综合征。尽管大多数情况下记录的是肘管综合征,但在上臂和下臂也发现了尺神经的机械性刺激。除临床检查外,电生理测试是治疗决策的最重要依据。根据临床表现,使用肘部夹板进行保守治疗可能是合适的。如果存在持续性或进展性神经刺激,手术减压可能是明智的干预措施。目前推荐开放或内镜辅助原位减压作为主要干预手段,而尺神经前移则推荐用于翻修手术。