Chang Wen Kai, Li Yong Ping, Zhang Deng Feng, Liang Bing Sheng
Department of Orthopaedics, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, Shanxi, China.
Department of Orthopaedics, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, Shanxi, China.
J Plast Reconstr Aesthet Surg. 2017 Oct;70(10):1404-1408. doi: 10.1016/j.bjps.2017.05.006. Epub 2017 Jul 6.
Cubital tunnel syndrome is the second most common nerve compression syndrome in peripheral nerve compression disease. Although potential ulnar nerve entrapment can occur at multiple points along its course, such as the arcade of struthers, the medial intermuscular septum, the medial epicondyle, the cubital tunnel, and the deep flexor pronator aponeurosis, the most common site of entrapment is the cubital tunnel. However, cubital tunnel syndrome could also be caused by the occupying masses along the course of ulnar nerve, such as intraneural or extraneural ganglia. The cubital tunnel syndrome caused by intraneural or extraneural ganglion cysts has been rarely reported. In our hospital, there were 184 patients with cubital tunnel syndrome who underwent surgical treatment from January 2010 to January 2014. Of these patients, 16 had extraneural cysts and 3 had intraneural ganglion cysts. The incidence rate of cysts in the cubital tunnel was 10.33%. Electromyography was used as routine examination. Ultrasound was used only in some patients in whom elbow mass was suspected. In the surgery of the cubital tunnel syndrome combined with cyst, if any other cysts were found, we should be remove completely the cyts and decompress the ulnar nerve thoroughly with the ulnar nerve being anterior transposition. These cysts were confirmed by histopathological examination. Finally, we compared the clinical features of patients who had a medial elbow ganglion with those of patients who had only cubital tunnel syndrome. B ultrasound can significantly improve the diagnosis. All patients were followed up for 4 months to 2 years, and the curative effect was good.
肘管综合征是周围神经卡压性疾病中第二常见的神经卡压综合征。尽管尺神经在其走行过程中的多个部位都可能发生潜在的卡压，如Struthers弓、内侧肌间隔、内上髁、肘管和深层屈肌旋前肌腱膜，但最常见的卡压部位是肘管。然而，肘管综合征也可能由沿尺神经走行的占位性肿块引起，如神经内或神经外神经节。由神经内或神经外神经节囊肿引起的肘管综合征鲜有报道。在我院，2010年1月至2014年1月期间有184例肘管综合征患者接受了手术治疗。在这些患者中，16例有神经外囊肿，3例有神经内神经节囊肿。肘管囊肿的发生率为10.33%。肌电图作为常规检查。仅在怀疑肘部有肿块的部分患者中使用超声检查。在合并囊肿的肘管综合征手术中，若发现其他囊肿，应彻底切除囊肿，并将尺神经前置，彻底松解尺神经。这些囊肿经组织病理学检查确诊。最后，我们比较了内侧肘部神经节患者与仅患有肘管综合征患者的临床特征。B超可显著提高诊断率。所有患者均随访4个月至2年，疗效良好。
