Mansat M, Bonnevialle P, Fine X, Guiraud B, Testut M F
Sem Hop. 1984 Feb 16;60(8):553-8.
Seventeen cases of late ulnar paralysis treated by neurolysis-transposition are reported. The clinical characteristics of these paralyses are emphasized: very prolonged symptom free interval, rapid onset and severe involvement. Ulnar transposition was most often done subcutaneously. Cubitus valgus and definite nerve compression proximal to the arcade of the flexor carpi ulnaris muscle are almost always present. The results as regards the neuropathy are undependable: no patient is completely cured and only half are improved. An anatomical study of the nerve path shows the essential role, in the compression of the nerve, of the muscular arcade of the flexor carpi ulnaris muscle which acts in a way similar to the bridge of a violin. Hence, opening it longitudinally is the principal step of neurolysis. This should be routine before the first signs of neuropathy occur in an elbow whose axis is out of alignment as a sequela of a childhood injury.
报告了17例采用神经松解转位术治疗的晚期尺神经麻痹病例。强调了这些麻痹的临床特征:症状缓解期非常长、起病迅速且受累严重。尺神经转位术最常经皮下进行。几乎总是存在肘外翻以及在尺侧腕屈肌肌拱近端有明确的神经受压情况。关于神经病变的结果不可靠:没有患者完全治愈,只有一半患者有所改善。对神经路径的解剖学研究表明,尺侧腕屈肌的肌拱在神经受压中起关键作用,其作用方式类似于小提琴的琴马。因此,纵向切开该肌拱是神经松解的主要步骤。对于因儿童期损伤后遗症导致肘部轴线不齐的情况,在神经病变的最初迹象出现之前,这应该作为常规操作。