骨间前神经卡压征的手术治疗

Surgical treatment of anterior interosseous nerve syndrome

目的 通过对手术后骨间前神经卡压征患者的随访 ,总结该病的手术治疗效果。方法 对 5例骨间前神经卡压征患者 ,在保守治疗无效后行神经松解术 ,3例行卡压神经的异常纤维束带切断术及神经外膜松解术 ,2例行神经外膜松解术。结果 5例患者均得到术后 1年的随访 ,以最后 1次的随访结果为准。 4例患者的拇长屈肌、示指指深屈肌、旋前方肌的肌力恢复到M4,但有 1例未见恢复。该例再行功能重建术 ,手部功能亦得到恢复。结论 前骨间神经卡压征是少见病 ,常易误诊 ,一旦确诊 ,经保守治疗无效 ,以神经松解术治疗为佳。

ObjectiveTo present the surgical outcome of anterior interosseous nerve entrapment.MethodsFive cases of anterior interosseous nerve syndrome that failed to conservative management were treated with surgical intervention. All these cases were followed for at least one year postoperatively, ranging from 1 year to 3 years.ResultsIntraoperative findings included aberrant fibrous bands in 3 cases and segmental scarring of the anterior interosseous nerve in 2 cases. Removal of the aberrant fibrous band and fascicular neurolysis were done, respectively. At last visit of follow up, M 4 muscle power of flexor pollicis longus, index flexor digitorum profundus and pronator quadratus was observed in 4 cases. There was no recovery in 1 case. That case was treated with secondary tendon transfer.ConclusionAnterior interosseous nerve entrapment is not common and can often be misdiagnosed. If conservative treatment for 3 months does not work, surgical intervention and neurolysis is indicated.