Abe M, Ishizu T, Shirai H, Okamoto M, Onomura T
Department of Orthopaedic Surgery, Osaka Medical College, Japan.
J Hand Surg Am. 1995 Jan;20(1):5-9. doi: 10.1016/S0363-5023(05)80047-4.
Fifteen patients with tardy ulnar nerve palsy caused by cubitus varus deformity were studied. All patients had a history of previous fracture of the humerus during childhood. The mean interval between fracture and onset of symptoms was 15 years. The severity of the palsy was classified as McGowan's grade I in 12 patients, grade II in 2 patients, and grade III in 1 patient. The mean carrying angle was -2 degrees before surgery. X-ray films showed a shallow ulnar nerve groove, a dysplastic humeral trochlea, medial shift of the ulna, and deformity of the medial epicondyle. The ulnar nerve was explored in all but one patient. Operative findings suggested that the main cause of the palsy was compression by a fibrous band running between the two heads of flexor carpi ulnaris. Surgical steps included release of the fibrous band in 14 patients with anterior subcutaneous transposition of the ulnar nerve in 5 of those patients. A corrective osteotomy was done in 11 patients who requested correction of the varus deformity. Traumatic cubitus varus deformity should be recognized as another cause of cubital tunnel syndrome.
对15例因肘内翻畸形导致迟发性尺神经麻痹的患者进行了研究。所有患者均有儿童期肱骨骨折史。骨折与症状出现的平均间隔时间为15年。12例患者的麻痹严重程度分类为麦高恩I级，2例为II级，1例为III级。术前平均提携角为-2度。X线片显示尺神经沟浅、肱骨滑车发育不良、尺骨内侧移位和内上髁畸形。除1例患者外，对所有患者均进行了尺神经探查。手术结果提示，麻痹的主要原因是尺侧腕屈肌两头之间的纤维带压迫。手术步骤包括14例患者松解纤维带，其中5例患者行尺神经前皮下移位。11例要求矫正内翻畸形的患者进行了矫正截骨术。创伤性肘内翻畸形应被视为肘管综合征的另一个病因。
