针刀“两点”松解法治疗肘管综合征的解剖基础与临床应用

Anatomical basis and clinical application of “two points” acupotomology surgery program in treating cubital tunnel syndrome

目的:探寻治疗肘管综合征的有效方法。方法:根据致病因素及肘管解剖结构,设计一种针刀"两点"松解法术式,分别松解弓状韧带在尺骨鹰嘴内侧缘及肱骨内上髁的附着点,对21例肘管综合征患者按该术式应用于临床并观察疗效。结果:术后1年回访,21例患者尺神经支配区皮肤麻木感消失,爪形手畸形及手内侧肌萎缩恢复明显。其中优17例,良2例,一般2例,差0例,优良率为90.5%。结论:针刀"两点"松解法切开了部分弓状韧带起止点,解决了因该韧带引起的尺神经卡压,是一种符合解剖结构、操作简单、创伤小、疗效满意的微创手术方法。

Objective To explore an effective acupotomology surgery program in treating cubital tunnel syn drome. Methods According to pathogenic factors and elbow anatomy, a ＂two points＂ acupotomology surgery program was designed, which could loose the attachment point of areuate ligament on medial border of olecroanon and medial epieondyle of humerus. Twenty-one cases of cubital tunnel syndrome were treated with acupotmotogy, then the efficacy was obsered. Results After one year postoperative visit, 21 patients with ulnar nerve area skin numbness were cured, claw hand deformity and medial hand muscle atrophy recovered significantly. Results of function evaluation were excellent in 17 cases, good in 2 cases, fair in 2 cases and poor in 0 cases, the good rate was 90.5%. Conclusion The acupotomology surgery program which could cut the starting and ending points of osborne＇s ligament and solve the problem of ulnar nerve entrapment is an easy, little-traumatic and effective minireally invasive surgery which also conforms to the anatomical structure.