Braun F M, Foucher G
SOS Main Clinique du Parc, Strasbourg.
Rev Chir Orthop Reparatrice Appar Mot. 1995;81(3):240-7.
Despite many publications concerning the physiopathology and the treatment of Ulnar tunnel syndrome treatment remains controversial.
The authors reviewed 51 patients operated on for ulnar nerve entrapment at the elbow by neurolysis combined with medial epicondylectomy in case of luxation or subluxation of the nerve. Average was 39 years, 74 per cent being males, 53 per cent manual workers. According to Mc Gowan's classification, 39 per cent were grade I, 12 per cent grade IIA, 20 per cent grade IIB and 29 per cent grade III.
Few postoperative complications occurred: one postoperative hematoma, 4 painful scars without neurinoma, and one case of an elbow extension lag of 15 degrees. With an average follow-up of 4.6 years, 39 per cent of the patients were cured, 27 per cent improved, 31 per cent unchanged and none worsened. As in all others techniques, excellent results only occurred in grade I and IIA.
Anatomical and physiopathological studies show that compression, friction and elongation are the 3 components of the ulnar tunnel syndrome. The different conservative and surgical treatments are analyzed, taking into account both advantages and drawbacks. The medial epicondylectomy with decompression allows a "mini transposition" of the nerve but keeps the vascularization and the nerve intact. Its simplicity and our results are confirmed by all other series analyzed in the literature.
尽管有许多关于尺管综合征生理病理学及治疗的出版物，但该疾病的治疗仍存在争议。
作者回顾了51例因肘部尺神经卡压而接受手术的患者，若神经出现脱位或半脱位，则采用神经松解术联合内上髁切除术。患者平均年龄39岁，74%为男性，53%为体力劳动者。根据麦高恩分类法，39%为I级，12%为IIA级，20%为IIB级，29%为III级。
术后并发症较少：1例术后血肿，4例无痛性瘢痕但无神经瘤，1例肘关节伸展滞后15度。平均随访4.6年，39%的患者治愈，27%改善，31%无变化，无患者病情恶化。与所有其他技术一样，仅I级和IIA级患者获得了优异的治疗效果。
解剖学和生理病理学研究表明，压迫、摩擦和牵拉是尺管综合征的三个构成要素。本文分析了不同保守治疗和手术治疗方法的优缺点。内上髁切除术联合减压术可使神经进行“微型转位”，但能保持神经的血供及完整性。其操作简便，我们的研究结果也得到了文献中分析的所有其他系列研究的证实。
