Lee Seung Hoo, Lee Ki Ho, Yoo Hye Jin
* Department of Orthopaedic surgery, Seoul National University College of Medicine, Seoul, Korea.
† Department of Orthopaedic Surgery, Armed Forces Yangju Hospital, Yangju, Korea.
J Hand Surg Asian Pac Vol. 2018 Sep;23(3):399-403. doi: 10.1142/S2424835518720232.
A 20-year-old male has presented with mild numbness and tingling sensation at 4, 5 finger of his left hand. Simple radiograph and MRI images revealed bony mass at medial joint space of ulno-humeral joint. After surgical exploration, we found that there were two cause of ulnar nerve irritation symptom. Fixed ulnar nerve position at anterior aspect to medial condyle with deficiency of nerve gliding was one cause, and friction irritation around bony mass was another. It is rarely reported that ulnar nerve always travels to the anterior side of the medial condyle of the elbow, and there are no cases involving skeletal variation. In this case, the ulnar nerve may be penetrated while forming an anterior medial portal around elbow joint. It is important to know the path of the ulnar nerves very carefully through imaging and physical examination when there is a bony variant in the elbow joint.
一名20岁男性患者左手无名指和小指出现轻度麻木和刺痛感。简单的X线片和MRI图像显示尺肱关节内侧关节间隙有骨质肿块。手术探查后，我们发现尺神经刺激症状有两个原因。尺神经在位于内侧髁前方位置固定且神经滑动不足是一个原因，骨质肿块周围的摩擦刺激是另一个原因。尺神经总是走行于肘关节内侧髁前方的情况鲜有报道，且没有涉及骨骼变异的病例。在本病例中，在肘关节周围形成前内侧入路时尺神经可能会被穿透。当肘关节存在骨质变异时，通过影像学检查和体格检查仔细了解尺神经的走行非常重要。
