Alp Nazmi Bülent, Akdağ Gökhan
Department of Orthopedics and Traumatology, Istanbul Bahçelievler State Hospital, Istanbul, Turkey.
Jt Dis Relat Surg. 2020;31(1):154-8. doi: 10.5606/ehc.2020.66993.
Although ganglions are the most common cause of ulnar tunnel syndrome, they are one of the rare causes of cubital tunnel syndrome (CuTS). In this article, we report a 49-year-old female patient admitted to the outpatient clinic complaining of numbness and tingling in the ring and little fingers of the right hand. There was no history of systemic disease or previous trauma. The patient was diagnosed with CuTS in the light of clinical examination and nerve conduction studies. Simple cubital tunnel decompression was performed under general anesthesia and microsurgical exploration revealed a 2x2 cm epineural ganglion cyst compressing the ulnar nerve. The cyst was excised without damaging the ulnar nerve and cutaneous nerves. Histopathology also confirmed the ganglion cyst. In the postoperative period, the patient's clinical improvement was more satisfactory than nerve conduction studies. The diagnosis of CuTS is established by physical examination, provocative test, and nerve conduction studies. In patients who cannot achieve a satisfactory outcome by conservative treatment, the cyst should be kept in mind among etiologic factors. Magnetic resonance imaging should be requested for accurate diagnosis and preoperative surgical planning.
尽管腱鞘囊肿是尺管综合征最常见的病因,但却是肘管综合征(CuTS)的罕见病因之一。在本文中,我们报告了一名49岁女性患者,她因右手环指和小指麻木及刺痛到门诊就诊。无全身性疾病史或既往外伤史。根据临床检查和神经传导研究,该患者被诊断为CuTS。在全身麻醉下进行了单纯肘管减压术,显微外科探查发现一个2×2 cm的神经外膜腱鞘囊肿压迫尺神经。囊肿被切除,未损伤尺神经和皮神经。组织病理学也证实为腱鞘囊肿。术后,患者的临床改善情况比神经传导研究结果更令人满意。CuTS的诊断通过体格检查、激发试验和神经传导研究来确立。对于保守治疗不能取得满意疗效的患者,病因因素中应考虑囊肿。应要求进行磁共振成像以获得准确诊断和术前手术规划。