手掌部尺骨神経障害

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タイトル別名
  • Ulnar Neuropathy at the Wrist

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<p>  Here, we report cases of 6 patients with ulnar neuropathy at the wrist (UNW). The patients included 3 women and 3 men with ages ranging from 30 to 56 years.</p><p>  On the basis of the patients' symptoms, we made a diagnosis of type Ⅰ UN (a mixed motor and sensory neuropathy) in 2 patients and of type Ⅳ UN (a pure motor neuropathy with sparing of hypothenar muscles) in the remaining 4 patients by using Wu's classification (1985). Surgery was performed for all patients, and the site of the compression and cause were confirmed. The ulnar nerve was compressed by the engorged vein of the arteriovenous fistula, anomalous muscle (large palmaris brevis muscle), aponeurosis of the hypothenar muscles at the pisohamate hiatus, and ganglion in 1, 1, 2, and 2 patients, respectively. Neurophysiological examination revealed distal latency to the hypothenar muscle to be normal in the patients with type Ⅳ UNW but that to the first dorsal interosseous muscle to be markedly prolonged in all cases. Although the reason why the hypothenar muscles were spared in these cases is still unclear, it might be the same as that underlying the fascicular phenomenon observed in cases of ulnar neuropathy at the elbow. Except for the results obtained for 2 patients with a long history of UNW before the operation, excellent results were obtained in the remaining patients.</p><p>  In conclusion, we would like to emphasize that, although signs and symptoms of UNW may vary according to the compression site and underlying causes, early diagnosis and surgical treatment may lead to favorable results.</p>

収録刊行物

  • 脊髄外科

    脊髄外科 26 (1), 68-73, 2012

    日本脊髄外科学会

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