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肘管综合征内侧上髁切除术的手术入路

The Surgical Approach to a Medial Epicondylectomy in Cubital Tunnel Syndrome.

作者信息

Burahee Abdus S, Duraku Liron S, Jose Rajive, Zuidam Michiel J, Power Dominic M

机构信息

From the The Peripheral Nerve Injury Service, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.

Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Amsterdam, The Netherlands.

出版信息

Plast Reconstr Surg Glob Open. 2025 Jun 10;13(6):e6861. doi: 10.1097/GOX.0000000000006861. eCollection 2025 Jun.

Abstract

Cubital tunnel syndrome, a common neuropathy of the upper limb, presents with sensory and motor symptoms, impacting hand function and grip strength. Surgical interventions, such as medial epicondylectomy (ME), aim to alleviate symptoms by relieving pressure on the ulnar nerve at the elbow. Historical attempts to treat this condition date back to the early 19th century, with procedures evolving over time. Modern techniques, including in situ decompression, transposition, and various forms of epicondylectomy, offer different approaches to address nerve compression. This article examined the evolution of ME techniques, highlighting the shift toward anatomical landmark-based referencing for precise osteotomy. Notably, adherence to consistent landmarks such as the ulnar collateral ligament and medial intermuscular septum ensures reproducibility and safety in surgical practice. Through meticulous dissection and osteotomy, ME aims to create a clear pathway for the ulnar nerve, reducing tension and preventing postoperative complications such as symptomatic nerve subluxation. Surgical success relies on thorough preoperative evaluation, precise technique execution, and attentive postoperative care. Complications, including nerve injury and joint instability, underscore the importance of surgical precision and patient monitoring. By prioritizing anatomical landmarks and using meticulous technique, ME offers a reliable solution for cubital tunnel syndrome, providing patients with improved function and symptom relief.

摘要

肘管综合征是上肢常见的神经病变,表现为感觉和运动症状,影响手部功能和握力。手术干预措施,如内侧上髁切除术(ME),旨在通过减轻肘部尺神经的压力来缓解症状。治疗这种疾病的历史尝试可追溯到19世纪初,手术方法随着时间不断演变。现代技术,包括原位减压、移位术和各种形式的内侧上髁切除术,提供了不同的方法来解决神经受压问题。本文探讨了内侧上髁切除术技术的演变,强调了向基于解剖标志的精确截骨术的转变。值得注意的是,遵循尺侧副韧带和内侧肌间隔等一致的标志可确保手术操作的可重复性和安全性。通过细致的解剖和截骨,内侧上髁切除术旨在为尺神经创造一条清晰的通道,减轻张力并预防术后并发症,如症状性神经半脱位。手术成功依赖于全面的术前评估、精确的技术操作和精心的术后护理。并发症,包括神经损伤和关节不稳定,凸显了手术精准度和患者监测的重要性。通过优先考虑解剖标志并采用细致的技术,内侧上髁切除术为肘管综合征提供了可靠的解决方案,为患者改善功能并缓解症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d448/12150908/b73f85c85799/gox-13-e6861-g001.jpg

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