Sindrom kubitalnog tunela

master's thesis

• Title (english): Cubital tunnel syndrome
• Author: Dominik Kancir
• Mentor: Ivan Bojanić (mentor)
• Committee member: Goran Bićanić (predsjednik povjerenstva)
• Committee member: Tomislav Smoljanović (član povjerenstva)
• Committee member: Ivan Bojanić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Orthopedics); Zagreb
• Defense date and country: 2015-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Orthopedics

Abstract

Sindrom kubitalnog tunela jest druga najčešća kompresivna neuropatija u ljudi nakon sindroma karpalnog kanala, a zahvaća ulnarni živac u području lakta. Kompresija ulnarnoga živca može se dogoditi na 5 mjesta u području lakta: područje medijalnoga intermuskularnoga septuma, medijalni epikondil nadlaktične kosti, epikondilarni žlijeb, kubitalni tunel i duboka aponeuroza fleksornih i pronatornih mišića, uz napomenu da je najčešće mjesto kompresije upravo kubitalni tunel. Do sindroma kubitalnog tunela dolazi zbog pritiska na živac ili zbog istezanja živca ili zbog kombinacije tih djelovanja. Klinička slika je raznovrsna te se kreće od smetnji osjeta, kao što su hipestezija te blage, intermitentne parestezije u inervacijskom području živca pa sve do atrofije mišića. Dijagnoza sindroma kubitalnog tunela postavlja se na osnovi anamneze i kliničkoga pregleda, a potrebno ju je potvrditi elektrofiziološkim dijagnostičkim pretragama. Početno je liječenje konzervativno, no ukoliko simptomi perzistiraju, a napose ukoliko je prisutna atrofija mišića, savjetuje se kirurško liječenje. Iako je u literaturi opisano nekoliko metoda kirurškoga liječenja sindroma kubitalnog tunela (jednostavna dekompresija, medijalna epikondilektomija, subkutana, intramuskularna i submuskularna antepozicija), još uvijek nije utvrđen zlatni standard. U suvremenoj literaturi opisana je i endoksopska dekompresija pa i endoskopska antepozicija ulnarnoga živca.

Abstract (english)

Cubital tunnel syndrome is the second most common compression neuropathy in men after carpal tunnel syndrome and includes ulnar nerve compression at the elbow. Ulnar nerve compression at the elbow can occur at 5 sites: area of the intermuscular septum, medial epicondyle, epicondylar groove, cubital tunnel and deep flexor pronator aponeurosis, but the most common site of compression is the cubital tunnel. Etiology of the cubital tunnel syndrome includes ulnar nerve compression or traction or their combination. Clinical findings vary from hypesthesia and mild, intermittent paresthesias in ulnar nerve distribution to muscle atrophy. The diagnosis of the cubital tunnel syndrome is based on patient's clinical history and physical examination and requires electrodiagnostic confirmation. Initial treatment is conservative but when patient has persistent symptoms, especially muscle atrophy, operative treatment should be considered. Despite several surgical procedures described in literature (simple decompression, medial epicondylectomy, subcutaneous, intramuscular and submuscular transposition), there is yet no golden standard. More recently, endoscopic decompression and endoscopic ulnar nerve transposition have been described.

• Keywords: ulnarni živac; kompresija; kubitalni tunel; dijagnostika; liječenje
• Keywords (english): ulnar nerve; compression; cubital tunnel; diagnostics; treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:105:842334
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-03-30 11:00:44