Barnum M, Mastey R D, Weiss A P, Akelman E
Department of Orthopaedics, Brown University School of Medicine, Rhode Island Hospital, Providence, USA.
Hand Clin. 1996 Nov;12(4):679-89.
Intermittent compression of the PIN within and just distal to the anatomic region known as the radial tunnel is responsible for a constellation of signs and symptoms known as radial tunnel syndrome. The five structures commonly implicated as possible offenders include the fibrous adhesions between the brachialis and brachioradialis, the leash of Henry, the fibrous edge of the ECRB, the arcade of Fröhse, and fibrous bands associated with the supinator muscle. The condition is dominated by pain centered over the radial tunnel, whereas muscle weakness, if present, is clinically insignificant. Specific attention to the character and point of maximal tenderness, worsening of pain on the provocative middle finger extension and resisted supination tests, and relief of symptoms following a radial tunnel anesthetic block help diagnose RTS. Electrodiagnostic testing presently has limited use in diagnosing RTS. The management of RTS includes activity modification and other conservative measures. Most patients, however, eventually require surgery, in which routine release of all potential constricting structures is performed. Although several surgical approaches are available, the brachioradialis-ERCL interval approach is one that has been very satisfying in our hands.
在被称为桡管的解剖区域内及该区域远侧对骨间后神经（PIN）进行间歇性压迫，会导致一系列被称为桡管综合征的体征和症状。通常被认为可能是病因的五个结构包括肱肌与肱桡肌之间的纤维粘连、亨利束、桡侧腕短伸肌的纤维边缘、弗罗泽弓以及与旋后肌相关的纤维束带。该病症主要表现为以桡管为中心的疼痛，而肌肉无力（若存在）在临床上并不显著。特别关注疼痛的性质、最痛点、在诱发的中指伸展和抗阻旋后试验中疼痛加重情况，以及桡管麻醉阻滞术后症状缓解情况，有助于诊断桡管综合征（RTS）。目前，电诊断测试在诊断RTS方面的应用有限。RTS的治疗包括调整活动及其他保守措施。然而，大多数患者最终需要手术，即对所有可能的压迫结构进行常规松解。尽管有几种手术方法可供选择，但肱桡肌 - 桡侧腕长伸肌间隙入路在我们的实践中效果非常令人满意。
