並列タイトル等肘の内外反変形に伴う尺骨神経の伸長度変化に関する生体力学的研究
タイトル（掲載誌）BMC musculoskeletal disorders
一般注記type:Thesis
Background: Cubital tunnel syndrome can be caused by overtraction and dynamic compression in elbow deformities.
The extent to which elbow deformities contribute to ulnar nerve strain is unknown. Here, we investigated ulnar
nerve strain caused by cubitus valgus/varus deformity using fresh-frozen cadavers.
Methods: We used six fresh-frozen cadaver upper extremities. A strain gauge was placed on the ulnar nerve 2 cm
proximal to the medial epicondyle of the humerus. For the elbow deformity model, osteotomy was performed at the
distal humerus, and plate fixation was performed to create cubitus valgus/varus deformities (10°, 20°, and 30°). Ulnar
nerve strain caused by elbow flexion (0–125°) was measured in both the normal and deformity models. The strains at
different elbow flexion angles within each model were compared, and the strains at elbow extension and at maximum
elbow flexion were compared between the normal model and each elbow deformity model. However, in the
cubitus varus model, the ulnar nerve deflected more than the measurable range of the strain gauge; elbow flexion
of 60° or more were considered effective values. Statistical analysis of the strain values was performed with Friedman
test, followed by the Williams’ test (the Shirley‒Williams’ test for non-parametric analysis).
Results: In all models, ulnar nerve strain increased significantly from elbow extension to maximal flexion (control:
13.2%; cubitus valgus 10°: 13.6%; cubitus valgus 20°: 13.5%; cubitus valgus 30°: 12.2%; cubitus varus 10°: 8.3%; cubitus
varus 20°: 8.2%; cubitus varus 30°: 6.3%, P < 0.001). The control and cubitus valgus models had similar values, but the
cubitus varus models revealed that this deformity caused ulnar nerve relaxation.
Conclusions: Ulnar nerve strain significantly increased during elbow flexion. No significant increase in strain 2 cm
proximal to the medial epicondyle was observed in the cubitus valgus model. Major changes may have been
observed in the measurement behind the medial epicondyle. In the cubitus varus model, the ulnar nerve was relaxed
during elbow extension, but this effect was reduced by elbow flexion.
博士（医学）・甲第865号・令和5年3月15日
© The Author(s) 2022.
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identifier:BMC musculoskeletal disorders Vol.23 No.1 Article No.829 (2022 Sep)
identifier:14712474
identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/4097
identifier:BMC musculoskeletal disorders, 23(1): Article No.829
関連情報（DOI）10.1186/s12891-022-05786-9
連携機関・データベース国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）
提供元機関・データベース奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU