Messina A, Messina J C
Traumatologic and Orthopaedic Hospital (CTO), Hand Surgery Centre, Torino, Italy.
J Hand Surg Br. 1995 Oct;20(5):638-48. doi: 10.1016/s0266-7681(05)80126-3.
Surgical findings show important alterations of the extrinsic and intrinsic vascularity of the ulnar nerve in the epitroclear groove. Current procedures are only able to solve the mechanical aspect of nerve compression. Transposition may cause additional iatrogenic ischaemic damage of endoneural vascularity if the nerve is separated from the ulnar collateral artery to achieve anterior mobilization. Our technique of transposition of the ulnar nerve with its vascular bundle maintains the advantages of anterior transposition currently in use, but is able to preserve the whole vascularity of the nerve, thus solving the biological aspect of nerve compression. This allows quicker recovery of axonal activity that was chronically compromised by the entrapment neuropathy. The technique and the results in 30 patients (90% excellent and good, 10% fair) treated since 1987 are presented.
手术结果显示，尺神经在上臂内上髁沟处的外在和内在血管存在重要改变。目前的手术方法仅能解决神经受压的机械问题。如果为了实现神经向前移位而将神经与尺侧副动脉分离，移位操作可能会导致额外的医源性神经内膜血管缺血性损伤。我们的尺神经及其血管束移位技术保留了目前常用的前移位术的优点，同时能够保留神经的全部血管，从而解决神经受压的生物学问题。这使得因卡压性神经病变而长期受损的轴突活性能够更快恢复。本文介绍了自1987年以来采用该技术治疗30例患者的情况（90%优和良，10%可）。
