Scratch Collapse Test Localizes Osborne’s Band as the Point of Maximal Nerve Compression in Cubital Tunnel Syndrome
Tóm tắt
The objective of this study is to demonstrate the utility of the scratch collapse test (SCT) in localizing the point of maximal compression in cubital tunnel syndrome. From January 1, 2004 to December 1, 2005, 64 adult patients with cubital tunnel syndrome were evaluated by a single surgeon. Cubital tunnel syndrome was diagnosed based upon symptoms of numbness, tingling, and/or pain in the ulnar nerve distribution or by the presence of weakness or wasting of the ulnar-innervated intrinsic hand muscles. All diagnoses were confirmed with electrodiagnostic studies. As part of the physical examination, the SCT was performed along three subdivided segments in the region of the cubital tunnel. Results of the SCT were recorded and correlated with intraoperative findings. Of the 64 patients evaluated, 44 had a positive SCT that was either more profound or solely present a few centimeters distal to the medial epicondyle in the region of Osborne’s band. All of these patients subsequently underwent anterior submuscular transposition and were found to have a tight compression point at Osborne’s band corresponding to their preoperative SCT. This study suggests that the scratch collapse test may be a reliable physical examination technique for localizing the point of maximal nerve compression in patients with cubital tunnel syndrome. That point, in this series, corresponded with Osborne’s band.
Tài liệu tham khảo
Adson AL. The surgical treatment of progressive ulnar paralysis. Minn Med. 1918;1:455–60.
Apfelberg DB, Larson SJ. Dynamic anatomy of the ulnar nerve at the elbow. Plast Reconstr Surg. 1973;51:76–81. doi:10.1097/00006534-197301000-00014.
Bartels RHMA, Menovsky T, Van Overbeeke JJ, et al. Surgical management of ulnar nerve compression at the elbow: an analysis of the literature. J Neurosurg. 1998;89:722–7.
Bartels RHMA, Verhagen WIM, Van Der Wilt GJ, et al. Prospective randomized controlled study comparing simple decompression versus anterior subcutaneous transposition for idiopathic neuropathy of the ulnar nerve at the elbow: part 1. Neurosurgery. 2005;56:522–30. doi:10.1227/01.NEU.0000154131.01167.03.
Beck JL. The P.A.N.E. process: basic principles and the first three tests. Practical application of neuropostural evaluations. Pract Pain Manage. 2008;8(7):47–53.
Cheng CJ, Mackinnon-Patterson B, Beck JL, Mackinnon SE. Scratch collapse test for evaluation of carpal and cubital tunnel syndrome. J Hand Surg [Am]. 2008;33(9):1518–24. doi:10.1016/j.jhsa.2008.05.022. Figures/tables reprinted with permission from Elsevier.
Dellon AL. Musculotendinous variations about the medial humeral epicondyle. J Hand Surg. 1986;11B:175–81.
Feindel W, Stratford J. Cubital tunnel compression in tardy ulnar palsy. CMAJ. 1958;78:351–3.
Floeter MK, Gerloff C, Kouri J, Hallett M. Cutaneous withdrawal reflexes of the upper extremity. Muscle Nerve. 1998;21:591–8. doi:10.1002/(SICI)1097-4598(199805)21:5<591::AID-MUS5>3.0.CO;2-3.
Hirasawa Y, Sawamura H, Sakakida K. Entrapment neuropathy due to bilateral epitrochleoanconeus muscles: a case report. J Hand Surg. 1979;4:181–4.
Inghilleri M, Conte A, Frasca V, Berardelli A, Manfredi M, Cruccu G. Is the cutaneous silent period an opiate-sensitive nociceptive reflex? Muscle Nerve. 2002;25:695–9. doi:10.1002/mus.10101.
Kane E, Kaplan EB, Spinner M. Observations on the course of the ulnar nerve in the arm. Ann Chir. 1973;27:470–96.
Kaneko K, Kawai S, Taguchi T, Fuchigami Y, Yonemura H, Fujimoto H. Cortical motor neuron excitability during cutaneous silent period. Electroencephalogr Clin Neurophysiol. 1998;109:364–8. doi:10.1016/S0924-980X(98)00031-9.
Kleinman WB. Revision ulnar neuroplasty. Hand Clin. 1994;10(3):461–77. Figure reprinted with permission from Elsevier.
Kleinman WB. Cubital tunnel syndrome: anterior transposition as a logical approach to complete nerve decompression. J Hand Surg. 1999;24(5):886–97. doi:10.1053/jhsu.1999.0886. Figures reprinted with permission from Elsevier.
Kofler M, Glocker FX, Leis AA, Seifert C, Wissel J, Kronenberg MF, et al. Modulation of upper extremity motoneuron excitability following noxious finger tip stimulation in man: a study with transcranial magnetic stimulation. Neurosci Lett. 1998;246:97–100. doi:10.1016/S0304-3940(98)00243-2.
Kofler M, Fuhr P, Leis AA, Glocker FX, Kronenberg MF, Wissel J, et al. Modulation of upper extremity motor evoked potentials by cutaneous afferents in humans. Clin Neurophysiol. 2001;112:1053–63. doi:10.1016/S1388-2457(01)00540-5.
MacKinnon SE, Dellon AL. Ulnar nerve entrapment at the elbow. In: MacKinnon SE, Dellon AL, editors. Surgery of the peripheral nerve. New York: Thieme Medical Publishers Inc; 1988.
McGowan AJ. The results of transposition of the ulnar nerve for traumatic ulnar neuritis. J Bone Joint Surg. 1950;32B:293–301.
Miller RG. The cubital tunnel syndrome: diagnosis and precise localization. Ann Neurol. 1979;6:56–9.
Osborne GV. The surgical treatment of tardy ulnar neuritis. J Bone Joint Surg Br. 1957;39B:782.
Polatsch DB, Melone CP, Beldner S, Incorvaia A. Ulnar nerve anatomy. Hand Clin. 2007;23:283–9. doi:10.1016/j.hcl.2007.05.001.
Richards RL. Traumatic ulnar neuritis: the results of anterior transposition of the ulnar nerve. Edinb Med J. 1945;52:14–21.
Shahani BT, Young RR. Studies of the normal human silent period. In: Desmedt JE, editor. New developments in electromyography and clinical neurophysiology. Basel: Karger; 1973. p. 589–602.
Sheldon WD. Tardy palsy of the ulnar nerve. Med Clin North Am. 1921;5:499–509.
Siquera MG, Martins RS. The controversial arcade of Struthers. Surg Neurol. 2005;64(Suppl 1:S1):17–20. discussion S1:20-1.
Spinner M. Management of nerve compression lesions in the upper extremity. In: Omer Jr GE, Spinner M, editors. Management of peripheral nerve problems. Philadelphia: WB Saunders Co; 1980.
Spinner M, Kaplan EB. The relationship of the ulnar nerve to the medial intermuscular septum in the arm and its clinical significance. Hand. 1976;8:239–42. doi:10.1016/0072-968X(76)90008-5.
Spinner M, Spencer PS. Nerve compression lesions of the upper extremity: a clinical and experimental review. Clin Orthop Relat Res. 1974;104:46–68. doi:10.1097/00003086-197410000-00007.
Struthers J. On a peculiarity of the humerus and humeral artery. Month J Med Sci. 1848;28:264–7.
Stuthers J. On some points in the abnormal anatomy of the arm. Br For Med Chir Rev. 1854;14:170–9.
Vanderpool DW, Chalmers J, Lamb DW, Whistson TB. Peripheral compression lesions of the ulnar nerve. J Bone Joint Surg. 1968;50B:792–802.
Wadsworth TG. The external compression syndrome of the ulnar nerve at the cubital tunnel. Clin Orthop Relat Res. 1977;124:189–204.
Zlowodzki M, Chan S, Bhandari M, Kalliainen L, Schubert W. Anterior transposition compared with simple decompression for treatment of cubital tunnel syndrome. A meta-analysis of randomized, controlled trials. J Bone Joint Surg Am. 2007;89:2591–8.
Mackinnon SE, Novak CB. Operative findings in reoperation of patients with cubital tunnel syndrome. Hand (N Y). 2007;2:137–43.