Bassett F H, Spinner R J, Schroeter T A
Division of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 27710.
Clin Orthop Relat Res. 1994 Oct(307):110-6.
Five patients presented with classic symptoms diagnostic of intermittent claudication that were exacerbated by strenuous activity. Examination demonstrated localized tenderness over the lacertus fibrosus (bicipital aponeurosis), as well as increased pain and an obliterated radial pulse with forearm pronation and resisted elbow flexion. All 5 were athletes who had hypertrophied forearm muscles. Patients were diagnosed with brachial artery compression by the lacertus fibrosus. Release of the lacertus fibrosus restored normal pulses in all cases. Followup ranged from 6 months to 25 years. Full clinical recovery was achieved in 3 patients. One patient had a good result and 1 a fair result. Although the lacertus fibrosus has been well described as a cause of neural compression and compartment syndrome, it has been reported only once to cause intermittent arterial compromise. Hypertrophy of the muscles and the lacertus fibrosus related to excessive use is an important factor in the development of isolated vascular, neural, or combined neurovascular lesions.
5例患者出现典型的间歇性跛行症状，剧烈活动会使其加重。检查发现肱二头肌肌腱膜（肱二头肌腱膜）处有局部压痛，前臂旋前和抗阻屈肘时疼痛加剧且桡动脉搏动消失。所有5例患者均为前臂肌肉肥大的运动员。患者被诊断为肱二头肌肌腱膜压迫肱动脉。所有病例中，松解肱二头肌肌腱膜后脉搏恢复正常。随访时间为6个月至25年。3例患者实现了完全临床康复。1例患者效果良好，1例效果尚可。尽管肱二头肌肌腱膜作为神经压迫和骨筋膜室综合征的病因已被充分描述，但仅有一次报道称其可导致间歇性动脉受压。与过度使用相关的肌肉和肱二头肌肌腱膜肥大是孤立性血管、神经或合并性神经血管病变发生发展的重要因素。
