Shulman Brandon, Bekisz Jonathan, Lopez Christopher, Maliha Samantha, Mahure Siddharth, Hacquebord Jacques
NYU Langone Orthopedic Hospital, New York City, USA.
NYU Langone Medical Center, New York City, USA.
Hand (N Y). 2020 May;15(3):335-340. doi: 10.1177/1558944718813669. Epub 2018 Nov 30.
Many patients treated for ulnar nerve compression at the elbow (UNE) are concomitantly treated for carpal tunnel syndrome (CTS). We sought to investigate the association between the conditions. The Statewide Planning and Research Cooperative System (SPARCS) database was used to determine the number of patients with UNE concomitantly treated for CTS in New York State from 2003 to 2014. We then retrospectively reviewed each patient who received surgical treatment for UNE (n = 222 patients) or CTS (n = 1063 patients) at our tertiary care institution in 2014 and 2015 to assess concomitant treatment. In the SPARCS database, the percentage of patients surgically treated for concomitant UNE and CTS steadily increased from 23% in 2003 to 45% in 2014. At our institution, 50 of 222 patients (23%) surgically treated for UNE underwent concomitant carpal tunnel releases. For concomitantly treated patients, 94% had examinations consistent with UNE and CTS, 87% of patients had median nerve compression on electrodiagnostic tests, and 72% of patients had UNE on electrodiagnostic tests. Most patients concomitantly treated for UNE and CTS have objective findings of both conditions. At least one-fourth of patients indicated for operative ulnar nerve release also require a carpal tunnel release-far beyond the prevalence of CTS in the general population. A diagnosis of UNE merits a comprehensive workup by the treating surgeon and a high suspicion for concomitant median nerve compression.
许多因肘部尺神经受压（UNE）接受治疗的患者同时也在接受腕管综合征（CTS）的治疗。我们试图研究这两种病症之间的关联。利用全州规划与研究合作系统（SPARCS）数据库来确定2003年至2014年纽约州同时接受CTS治疗的UNE患者数量。然后，我们回顾性分析了2014年和2015年在我们三级医疗机构接受UNE手术治疗的每位患者（n = 222例患者）或CTS手术治疗的患者（n = 1063例患者），以评估同时进行的治疗情况。在SPARCS数据库中，接受UNE和CTS联合手术治疗的患者百分比从2003年的23%稳步上升至2014年的45%。在我们机构，222例接受UNE手术治疗的患者中有50例（23%）同时进行了腕管松解术。对于同时接受治疗的患者，94%的检查结果符合UNE和CTS，87%的患者在电诊断测试中有正中神经受压，72%的患者在电诊断测试中有UNE。大多数同时接受UNE和CTS治疗的患者都有这两种病症的客观表现。至少四分之一需要进行尺神经松解手术的患者也需要进行腕管松解术——这远远超过了普通人群中CTS的患病率。UNE的诊断值得主刀医生进行全面检查，并高度怀疑同时存在正中神经受压。
