肘管综合症的治疗常文凯教授.PPT

术后恢复体会 肌力：可有明显增加，手的精细动作改善。有报道十年病史的肌肉萎缩也有手术的价值。 皮肤感觉：有明显改善，但是不能完全恢复。“麻”可消失，“木”可能会残留。 提示：需要降低患者期望值！ 值得继续关注的问题 前置术后滑脱：对手术疗效影响未必很大？ 轻度肘管综合症：局部封闭治疗的效果？ 中度以下的肘管综合症是否需要前置？ 神经内囊肿文献 Boston 1994年 1例Compression of the ulnar nerve at the elbow in association with synovial cysts 奥地利1例1999 Sonographic Diagnosis of Recurrent Ulnar Nerve Compression by Ganglion Cysts . the American Institute of Ultrasound in Medicine ? J Ultrasound Med 18:433–436, 1999 阿曼苏丹2000 ganglion cyst of the ulnar nerve in the cubital tunnel 加拿大1例神经内囊肿 2003 Compression of the ulnar nerve at the elbow by an intraneural ganglion.J Clin Neurosci. 2003 Mar;10(2):245-8. 土耳其1例2005 Ulnar nerve entrapment neuropathy due to extraneural ganglia at the elbow(Turkish) Journal of Neurological Sciences 2005, Volume 22, Number 1, Page(s) 079-083 上海1例Microsurgical principles related to excision of intraneural ganglion at the elbow 希腊2007 Ulnar Nerve Compression in the Cubital Tunnel by an Epineural Ganglion: A Case Report Loukas A. Boursinos Christos G. Dimitriou Department of Orthopaedics, General University Hospital Hippokration, 54642 Thessaloniki, Greece 2010山西基层医院 前臂腱鞘囊肿致尺神经卡压12例 合并囊肿的发病率 elbow ganglia originating from ulnahumeral joint is reported as a rare cause 3, 8, 14. Its prevalence患病率 is reported as 3 to 8 % for cubital tunnel syndrome patients in the literature ?zgür TA?KAPILIO?LU , Ahmet BEKAR , M. Erim KüR?AT , Ulviye . Ulnar nerve entrapment neuropathy due to extraneural ganglia at the elbow: A case report Journal of Neurological Sciences (Turkish) 2005, Volume 22, Number 1, Page(s) 079-083 北海道的数据 472例病人的大样本研究 Medial elbow ganglion was the third most common causative factor associated with cubital tunnel syndrome, with an overall prevalence of 8% Kato H, Hirayama T, Minami A, Iwasaki N, Hirachi K. Cubital tunnel syndrome associated with medial elbow ganglia and osteoartritis of the elbow. J Bone and Joint Surg 2002; 84(8): 1413-1419 腱鞘囊肿是诱发CuTS的重要因素，B超应该做为术前诊断的常规检查 肘管综合症 囊肿 阳性率 B超组 34 12 （7例术中证