Reddy M P
Arch Phys Med Rehabil. 1984 Jan;65(1):24-6.
Five cases are reported of upper extremity amputation with no metabolic disease. Patients experienced pain, paresthesia and weakness in the intact extremity associated with electrophysiologic evidence of entrapment neuropathies. All patients did heavy manual work, and all had carpal tunnel syndrome. One patient also had cubital tunnel syndrome and compression of the medial cord of the brachial plexus in the axilla, and another patient had cubital tunnel syndrome and axillary neuropathy. Surgery did not relieve symptoms of carpal tunnel and cubital tunnel syndromes for prosthesis users until the figure-8 harness was changed. Patients who did not use a prosthesis felt relief of symptoms following surgical release. Possible mechanisms which produce nerve entrapment syndromes in patients with upper extremity amputations are use of one limb for heavy manual work over prolonged periods, direct compression of neural structures from the axilla loop of a figure-8 harness, and compression of neural structures in the axilla resulting in entrapment at a distal site. Changing the figure-8 harness should be considered prior to surgical decompression for patients who have upper extremity amputations with entrapment syndromes.
报告了5例无代谢疾病的上肢截肢病例。患者在完整肢体上出现疼痛、感觉异常和无力，伴有卡压性神经病的电生理证据。所有患者都从事重体力劳动，且均患有腕管综合征。1例患者还患有肘管综合征和腋窝处臂丛内侧束受压，另1例患者患有肘管综合征和腋神经病变。对于使用假肢的患者，在改变8字形吊带之前，手术并未缓解腕管和肘管综合征的症状。未使用假肢的患者在手术松解后症状得到缓解。在上肢截肢患者中产生神经卡压综合征的可能机制包括长时间使用单肢进行重体力劳动、8字形吊带腋窝环对神经结构的直接压迫以及腋窝处神经结构受压导致远端部位卡压。对于患有上肢截肢伴卡压综合征的患者，在手术减压之前应考虑更换8字形吊带。
