肘管的解剖特点对原位松解术治疗肘管综合征的疗效影响

发布时间：2018-05-13 17:19

本文选题：肘管综合征 + 肘管支持带　；参考：《中国临床解剖学杂志》2017年04期

【摘要】：目的探讨肘管的解剖特点,为肘管综合征的手术方式的选择提供参考意义。方法选取81例肘管综合征患者,依据其肘管的解剖构造特点分为A、B两组,A组:肘管支持带的厚度≥1.4 mm者,或者肘管支持带被滑车上肘肌取代者,共39例,B组:肘管支持带的厚度1.4 mm者,共42例,均实施尺神经原位松解术,术后随访12个月,我们将两组的有效率进行比较。结果两组的有效率具有显著差异(P0.05),A组的有效率为92.31%,B组的有效率为76.19%。结论对于肘管支持带较厚者,或者直接被滑车上肘肌的患者,引发肘管综合征的病因考虑为被增厚的弓状韧带或者被滑车上肘肌卡压,故实施尺神经原位松解术的效果好,而肘管支持带相对较薄者,实施尺神经原位松解术治疗效果较差,考虑这类肘管综合征患者为尺神经完全屈肘时遭到牵拉引起,而非卡压造成。
[Abstract]:Objective to study the anatomic characteristics of cubital tunnel and to provide reference for the choice of operation mode of cubital tunnel syndrome. Methods Eighty-one patients with cubital tunnel syndrome were divided into two groups according to the anatomic characteristics of cubital tunnel. Group A was divided into two groups: the thickness of the cubital retinaculum was more than 1.4 mm, or the cubital retinaculum was replaced by the superior cubital muscle of the trochlear. In group B, the thickness of the cubital retinaculum was 1.4 mm, 42 cases were treated with ulnar nerve in situ lysis. The follow-up was 12 months. The effective rate of the two groups was compared. Results the effective rate of group A was 92.31% and that of group B was 76.19%. Conclusion for the patients with thicker cubital retinaculum, or directly by the superior cubital muscle of the trochlear, the etiology of the cubital tunnel syndrome is considered to be the thickened arcuate ligament or the compression of the superior cubital muscle of the trochlear, so the effect of in situ decompression of the ulnar nerve is good. However, the results of in situ decompression of the ulnar nerve in patients with cubital tunnel were relatively thin. The patients with cubital tunnel syndrome were caused by traction of ulnar nerve when they were completely elbow flexion, rather than by compression.
【作者单位】：邢台市第三医院骨科;
【分类号】：R688

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