Journal of Korean Neurosurgical Society

  • 제61권5호
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  • Pages.618-624
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  • 2018
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Cubital Tunnel Syndrome Caused by Anconeus Epitrochlearis Muscle

  • Park, Il-Jung (Department of Orthopaedic Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Hyoung-Min (Department of Orthopaedic Surgery, Good Samsun Hospital) ;
  • Lee, Jae-Young (Department of Orthopaedic Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Jeong, Changhoon (Department of Orthopaedic Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kang, Younghoon (Department of Orthopaedic Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Hwang, Sunwook (Department of Orthopaedic Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Sung, Byung-Yoon (Department of Orthopaedic Surgery, St. Mary's Spine & Joint Hospital) ;
  • Kang, Soo-Hwan (Department of Orthopaedic Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea)
  • 투고 : 2018.02.09
  • 심사 : 2018.05.04
  • 발행 : 2018.09.01
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초록

Objective : We evaluated the clinical manifestation and surgical results following operative treatment of cubital tunnel syndrome (CuTS) caused by anconeus epitrochlearis (AE) muscle. Methods : Among 142 patients who underwent surgery for CuTS from November 2007 to October 2015, 12 were assigned to the AE group based on discovery of AE muscle; 130 patients were assigned to the other group. We analyzed retrospectively; age, sex, dominant hand, symptom duration, and weakness in hand. Severity of the disease was evaluated using the Dellon classification and postoperative symptom were evaluated using disability of arm shoulder and hand (DASH) and visual analogue scale (VAS) scores. Surgery consisted of subfascial anterior transposition following excision of AE muscle. Results : AE muscle was present in 8.5% of all patients, and was more common in patients who were younger and with involvement of their dominant hand; the duration of symptom was shorter in patients with AE muscle. All patients showed postoperative improvement in symptoms according to DASH and VAS scores. Conclusion : The possibility of CuTS caused by AE muscle should be considered when younger patients have rapidly aggravated and activity-related cubital tunnel symptoms with a palpable mass in the cubital tunnel area. Excision of AE muscle and anterior ulnar nerve transposition may be considered effective surgical treatment.

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참고문헌

  1. Assmus H, Antoniadis G, Bischoff C, Hoffmann R, Martini AK, Preissler P, et al. : Cubital tunnel syndrome - a review and management guidelines. Cent Eur Neurosurg 72 : 90-98, 2011 https://doi.org/10.1055/s-0031-1271800
  2. Boero S, Senes FM, Catena N : Pediatric cubital tunnel syndrome by anconeus epitrochlearis: a case report. J Shoulder Elbow Surg 18 : e21-e23, 2009
  3. Bozentka DJ : Cubital tunnel syndrome pathophysiology. Clin Orthop Relat Res 351 : 90-94, 1998
  4. Byun SD, Kim CH, Jeon IH : Ulnar neuropathy caused by an anconeus epitrochlearis: Clinical and electrophysiological findings. J Hand Surg Eur Vol 36 : 607-608, 2011 https://doi.org/10.1177/1753193411412149
  5. Capdarest-Arest N, Gonzalez JP, Turker T : Hypotheses for ongoing evolution of muscles of the upper extremity. Med Hypotheses 82 : 452-456, 2014 https://doi.org/10.1016/j.mehy.2014.01.021
  6. Chalmers J : Unusual causes of peripheral nerve compression. Hand 10 : 168-175, 1978
  7. Cho YJ, Cho SM, Sheen SH, Choi JH, Huh DH, Song JH : Simple decompression of the ulnar nerve for cubital tunnel syndrome. J Korean Neurosurg Soc 42 : 382-387, 2007 https://doi.org/10.3340/jkns.2007.42.5.382
  8. Dekelver I, Van Glabbeek F, Dijs H, Stassijns G : Bilateral ulnar nerve entrapment by the M. anconeus epitrochlearis. A case report and literature review. Clin Rheumatol 31 : 1139-1142, 2012 https://doi.org/10.1007/s10067-012-1991-7
  9. Erdem Bagatur A, Yalcin MB, Ozer UE : Anconeus epitrochlearis muscle causing ulnar neuropathy at the elbow: clinical and neurophysiological differential diagnosis. Orthopedics 39 : e988-e991, 2016 https://doi.org/10.3928/01477447-20160623-11
  10. Fernandez J, Camuzard O, Gauci MO, Winter M : A rare cause of ulnar nerve entrapment at the elbow area illustrated by six cases: the anconeus epitrochlearis muscle. Chir Main 34 : 294-299, 2015 https://doi.org/10.1016/j.main.2015.09.005
  11. Gervasio O, Zaccone C : Surgical approach to ulnar nerve compression at the elbow caused by the epitrochleoanconeus muscle and a prominent medial head of the triceps. Neurosurgery 62 (3 Suppl 1) : 186-192, 2008 https://doi.org/10.1227/01.neu.0000317392.29551.aa
  12. Hirasawa Y, Sawamura H, Sakakida K : Entrapment neuropathy due to bilateral epitrochleoanconeus muscles: a case report. J Hand Surg Am 4 : 181-184, 1979 https://doi.org/10.1016/S0363-5023(79)80139-2
  13. Hodgkinson PD, McLean NR : Ulnar nerve entrapment due to epitrochleo-anconeus muscle. J Hand Surg Br 19 : 706-708, 1994
  14. Kato H, Hirayama T, Minami A, Iwasaki N, Hirachi K : Cubital tunnel syndrome associated with medial elbow ganglia and osteoarthritis of the elbow. J Bone Joint Surg Am 84 : 1413-1419, 2002 https://doi.org/10.2106/00004623-200208000-00018
  15. Lee SU, Kim MW, Kim JM : Ultrasound diagnosis of double crush syndrome of the ulnar nerve by the anconeus epitrochlearis and a ganglion. J Korean Neurosurg Soc 59 : 75-77, 2016
  16. Masear VR, Hill JJ Jr, Cohen SM : Ulnar compression neuropathy secondary to theanconeus epitrochlearis muscle. J Hand Surg Am 13 : 720-724, 1988 https://doi.org/10.1016/S0363-5023(88)80133-3
  17. Morgenstein A, Lourie G, Miller B : Anconeus epitrochlearis muscle causing dynamic cubital tunnel syndrome: a case series. J Hand Surg Eur Vol 41 : 227-229, 2016 https://doi.org/10.1177/1753193414559491
  18. Nellans K, Galdi B, Kim HM, Levine WN : Ulnar neuropathy as a result of anconeus epitrochlearis. Orthopedics 37 : e743-e745, 2014 https://doi.org/10.3928/01477447-20140728-92
  19. O'Driscoll SW, Horii E, Carmichael SW, Morrey BF : The cubital tunnel and ulnar neuropathy. J Bone Joint Surg Br 73 : 613-617, 1991
  20. O'Hara JJ, Stone JH : Ulnar nerve compression at the elbow caused by a prominent medial head of the triceps and an anconeus epitrochlearis muscle. J Hand Surg Br 21 : 133-135, 1996 https://doi.org/10.1016/S0266-7681(96)80029-5
  21. Posner MA : Compressive ulnar neuropathies at the elbow: I. Etiology and diagnosis. J Am Acad Orthop Surg 6 : 282-288, 1998 https://doi.org/10.5435/00124635-199809000-00003
  22. Tiong WH, Kelly J : Ulnar nerve entrapment by anconeus epitrochlearis ligament. Hand Surg 17 : 83-84, 2012 https://doi.org/10.1142/S021881041272001X
  23. Uscetin I, Bingol D, Ozkaya O, Orman C, Akan M : Ulnar nerve compression at the elbow caused by the epitrochleoanconeus muscle: a case report and surgical approach. Turk Neurosurg 24 : 266-271, 2014
  24. Wilson TJ, Tubbs RS, Yang LJ : The anconeus epitrochlearis muscle may protect against the development of cubital tunnel syndrome: a preliminary study. J Neurosurg 125 : 1533-1538, 2016 https://doi.org/10.3171/2015.10.JNS151668

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