Privat J M, Allieu Y, Frerebeau P, Benezech J, Gros C
Neurochirurgie. 1979;25(4):239-43.
Radial nerve compression palsies at the elbow and forearm result in a lower radial nerve palsy whose clinical data are generally a hardly diagnosed dissociated radial palsy, or a rough paresis in the range of epicondylalgia. Apparently spontaneous non traumatic compressions are rare. They are essentially due to lipomas, to fibromas, or sometimes to synovial cysts of the elbow. In the course of rheumatoid arthritis, palsies must be isolated. Besides, there is an actual inflammatory canal syndrome of epicondylalgias range, in which radial nerve paresis must be investigated. Traumatic compressions are essentially due to Mongeggia fractures. Radial nerve injury at the elbow is explained by a real radial canal being, in which the nerve is entrapped and where it is especially fixed on a level of its entering the supinator brevis. Any addition of a pathological element in that area (traumatic or not, tumoral or inflammatory) will be able to involve a compression and a nerve stretching, on a level of the arch of Frohse, essentially. Surgical treatment in non traumatic compressions enables to give the etiological diagnosis and to warrant healing by opening the radial canal excising the added pathological element. To achieve a total surgical operation, in epicondylalgias, the surgeons will have to open this radial canal, as well. Traumatic compressions will be explored only in cases of non spontaneous recovery, after treating the osteoarticular injury.
肘部和前臂的桡神经受压麻痹会导致下桡神经麻痹,其临床数据通常是难以诊断的分离性桡神经麻痹,或在肱骨外上髁炎范围内的大致轻瘫。明显自发的非创伤性压迫很少见。它们主要是由于脂肪瘤、纤维瘤,或有时是肘部的滑膜囊肿。在类风湿性关节炎病程中,麻痹必须是孤立的。此外,存在肱骨外上髁炎范围内实际的炎性管综合征,其中必须对桡神经轻瘫进行检查。创伤性压迫主要是由于孟氏骨折。肘部桡神经损伤是由一个真正的桡神经管解释的,神经在该管内被卡压,并且在其进入旋前圆肌短头的水平处特别固定。该区域任何病理性因素的增加(创伤性或非创伤性、肿瘤性或炎性)都可能在弗罗瑟弓水平导致压迫和神经拉伸。非创伤性压迫的手术治疗能够通过打开桡神经管切除额外的病理性因素来做出病因诊断并确保愈合。为了在肱骨外上髁炎中完成全面的手术操作,外科医生也必须打开这个桡神经管。只有在治疗骨关节损伤后非自发恢复的情况下才会探查创伤性压迫。