Ruch D S, Poehling G G
Department of Orthopaedic Surgery, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27157-1070, USA.
Arthroscopy. 1997 Dec;13(6):756-8. doi: 10.1016/s0749-8063(97)90014-1.
Elbow arthroscopy is becoming an increasingly invaluable tool for both evaluation of and treatment of a variety of interarticular disease processes. Case reports have documented radial and posterior interosseus injuries following anterior capsular release. To date, this is the first report of an anterior interosseus nerve injury following arthroscopic surgery of the elbow. Arthroscopic surgery offers unparalleled visualization of the multiple articulations and facets of the elbow. It has been reported as useful for removal of loose bodies, synovectomy, release of arthrofibrosis, and the treatment of osteochondritis dessicans. However, the technique does require thorough knowledge of neurovascular structures about the elbow as well as appreciation of the protective layers including the capsule, brachialis, and brachioradialis muscles. This report documents direct injury to the anterior interosseus branch of the median nerve during an elbow debridement and synovectomy in a 65-year-old patient with rheumatoid arthritis.
肘关节镜检查正日益成为评估和治疗各种关节内疾病过程的一项极为重要的工具。病例报告记录了前关节囊松解术后出现的桡神经和骨间后神经损伤。迄今为止，这是肘关节镜手术后发生骨间前神经损伤的首例报告。关节镜手术能提供肘关节多个关节和小面无与伦比的可视化效果。据报道，它对取出游离体、滑膜切除术、关节纤维性粘连松解以及剥脱性骨软骨炎的治疗很有用。然而，该技术确实需要对肘关节周围的神经血管结构有透彻的了解，以及对包括关节囊、肱肌和肱桡肌在内的保护层有所认识。本报告记录了一名65岁类风湿关节炎患者在肘关节清创和滑膜切除术中正中神经骨间前支的直接损伤。
