【作者】 沙轲；

【导师】 韦黄度； 陈德松； 苏方荣； 黄仲麒； 杨志；

【作者基本信息】 广西医科大学 ， 手外科， 2000， 硕士

【摘要】 目的：1.研究尺神经手背支卡压引起腕尺侧痛的机理。 2.探讨尺神经手背支卡压症的诊断和治疗。 方法：对40侧成人尸体前臂部和腕部进行大体解剖和显微解剖，研究尺神经手背支，观测了该支的走行、分支及其支配区域，观察了被动活动腕关节对手背支各终末支的影响。在临床上诊治了13例尺神经手背支卡压的病例并进行分析。 结果：尺神经手背支在尺骨茎突以近5.6～6.8CM处尺侧腕屈肌深面自尺神经主干发出，然后斜向内下方走行，穿离尺侧腕屈肌腱的深层，紧贴尺骨头尺侧并转向手背。尺神经手背支在尺骨头水平分成2～3大支，每支均能找到进入骨关节和韧带的终末支。腕关节活动引起尺骨头相对位置的改变，极易对手背支造成牵拉，尤以横支明显。临床发现患该症的病人尺骨头远端或几侧缘有一显著而局限的压痛点，其周围有局部的皮肤感觉改变。13个病例中，7例局封，6例手术，其中9例随访4月～1年，未见复发。 结论：腕关节反复屈伸时尺神经手背支被牵拉和压迫是造成尺神经手背支卡压症的解剖学基础，横支的卡压很可能是引起腕尺侧痛的主要原因。临床上对有腕尺侧痛和皮肤感觉改变的病例，应考虑尺神经稍支卡压的可能性。更多还原

【Abstract】 objectives：To Investigate the mechanism of ulnar sided． rlst pain Induced by compression of the dorsal branch of ulnar nerve. Methods：Anatomical studies were done on 40 sides of dorsal branch of ulnar nerve in adult cadavers．The anatomy of this branchand its relation to the surroundingwas observed grosslyandmlcrography．Duringpasslve wrist flexlon and extension，the dorsal branch of ulnar nerve was observed．13 patients with dorsal branch ofulnar nerve compression were treated clinically． Results：The dorsal branch of ulnar nerve ran along the ulnar after leaving from the ulnar sided of the muscle flexor carpi ulnaris，then gave off 2 to 3 branches by ulnar sided of the the ulna capitulum．The transverse branch is very closed to the perlsteam when it crossing the ulna capltulum or distal side of the ulna cppitulum．Repeated movements of wrist and alterment of ulna capltulum is easy to injure this branch． Local injection and surgery is effective to decrease the symptoms． Conclusions：The repetitive traction and compression on the dorsal branch of ulnar nerve duringwrlst flexlon and extension Is the anatomical foundation of the dorsal branch of ulnar nerve compression．The compression of dorsal branch of ulnar nerve should be consldeled when we treating a patient whose have ulnar side wrist pain and abnormal sense．更多还原