Masear V R, Hill J J, Cohen S M
Division of Orthopaedic Surgery, University of Alabama, Birmingham 35233.
J Hand Surg Am. 1988 Sep;13(5):720-4. doi: 10.1016/s0363-5023(88)80133-3.
The treatment of the five arms of four patients with ulnar neuropathy at the elbow and an associated anconeus epitrochlearis muscle is presented. Two of these patients had unilateral involvement, one had bilateral neuropathy and bilateral anconeus epitrochlearis muscles, and one had bilateral symptoms, with an anconeus epitrochlearis muscle on the side that was treated by operation. All patients were treated with excision of the anconeus epitrochlearis muscle and cubital tunnel release without anterior transposition of the nerve. All five arms were clinically normal at follow-up 16 to 29 months after operation. Postoperative electrodiagnostic studies on four arms at an average of 9 months after operation showed marked improvement in conduction velocities across the elbow. We recommend simple excision of the anomalous anconeus epitrochlearis muscle when no other cause of ulnar nerve neuropathy at the elbow is identified. Anterior transposition of the nerve seems unnecessary.
本文介绍了4例肘部尺神经病变合并肱三头肌内侧头相关肌肉的5个上肢的治疗情况。其中2例为单侧病变，1例为双侧神经病变及双侧肱三头肌内侧头，1例有双侧症状，手术治疗侧有肱三头肌内侧头。所有患者均接受了肱三头肌内侧头肌切除及肘管松解术，未进行神经前置。术后16至29个月随访时，所有5个上肢临床均恢复正常。术后平均9个月对4个上肢进行的电诊断研究显示，肘部传导速度有显著改善。当未发现肘部尺神经病变的其他原因时，我们建议单纯切除异常的肱三头肌内侧头肌。神经前置似乎没有必要。
