Riche-Cannieu吻合支对腕管综合征诊断的影响

The effect of Riche-Cannieu anastomosis on the diagnosis of patients with carpal tunnel syndrome

目的了解Riche-Cannieu吻合支(尺神经深支与正中神经返支在手掌中的变异吻合支)对腕管综合征诊断的影响。方法总结12例腕管综合征合并存在Riche-Cannieu吻合支的病例,其中男2例,女10例,平均年龄49.8岁,就其解剖基础、临床表现、电生理表现以及诊断进行讨论。结果由于存在Riche-Cannieu吻合支,腕管综合征患者的拇短展肌得以保留部分甚至全部功能,导致其腕管综合征病变程度与其临床表现、电生理表现不符。结论充分了解Riche-Cannieu吻合支这一解剖变异的特点,对临床诊断和治疗腕管综合征具有重要的意义,同时也可避免错误地解释腕管综合征患者的电生理检测结果。

Objective To study the effect of the Riche-Cannieu anastomosis, an anomalous anastomosis between the deep branch of ulnar nerve and the recurrent branch of median nerve in the palm of the hand, on the diagnosis of patients with carpal tunnel syndrome. Methods Twelve patients （2 male, 10 female, mean age 49.8 years） with carpal tunnel syndrome with the presence of Riche-Cannieu anastomosis were tested in this study. Their clinical data including the symptoms and signs, electrophysiological findings and diagnosis were collected and discussed in relation to an anatomical review of these nerves. Results Due to the existence of the Riche-Cannieu anastomosis, the patients with carpal tunnel syndrome spared part or all of the function of the abductor pollicis brevis （APB） muscle. It may result in an unconformity of the patients＇lesion degree caused by carpal tunnel syndrome and its clinical symptoms and electrophysiological findings. Conclusion Knowledge of the Riche-Cannieu anastomosis is of crucial importance in the clinical evaluation, diagnosis and treatment of carpal tunnel syndrome, as well as in avoiding errors in interpreting the electrophysiological data of the patients.