臂外侧肌间隔卡压综合征及其防治

Entrapment syndrome of lateral intermuscular septum of arm and its treatment and prevention

目的 探讨肱骨骨折后桡神经卡压的发病机制和防治方法。方法 在防腐尸体标本上进行臂部桡神经行程观察。 7例肱骨骨折治疗后迟发性桡神经卡压 ,行臂外侧肌间隔切开松解桡神经。根据其发病机制命名为臂外侧肌间隔卡压综合征。结果 根据中华医学会手外科学会桡神经修复后功能评定试用标准 ,优 6例 ,良 1例。结论 臂外侧肌间隔是肱骨骨折后桡神经卡压发生的决定性因素 ,臂外侧肌间隔切开是治疗和预防的有效方法。肱骨骨折的良好复位、用带锁髓内钉固定或调整好钢板位置 ,均能预防臂外侧肌间隔卡压综合征。

Objective To investigate the pathogenesis and prevention or treatment method of entrapment syndrome of lateral intermuscular septum of arm after treatment of humeral fractures.Methods Five antisepticized cadaver arms were used to observe the path of radial nerve.Incision of the lateral intermuscular septum of arm and neurolysis of the compressed nerve were performed on 7 patients with tardy entrapment of radial nerve after treatment of humeral fractures.It was named entrapment syndrome of lateral intermuscular septum of arm for its pathogenesis.Results According to the criteria of functional recovery of radial nerve,Hand Surgery Association of China Medical Association,6 cases were excellent,1 was good.Conclusion The lateral intermuscular septum of arm is the decisive cause of the compression of radial nerve after treatment of humeral fractures.Incision of it can prevent and cure the syndrome.Satisfactory reduction of the fractures,the use of intramedullary nail or the proper location of plate can prevent the entrapment syndrome of lateral intermuscular septum of arm.