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
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 ulnarnerve 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 cmproximal to the medial epicondyle of the humerus. For the elbow deformity model, osteotomy was performed at thedistal humerus, and plate fixation was performed to create cubitus valgus/varus deformities (10°, 20°, and 30°). Ulnarnerve strain caused by elbow flexion (0–125°) was measured in both the normal and deformity models. The strains atdifferent elbow flexion angles within each model were compared, and the strains at elbow extension and at maximumelbow flexion were compared between the normal model and each elbow deformity model. However, in thecubitus varus model, the ulnar nerve deflected more than the measurable range of the strain gauge; elbow flexionof 60° or more were considered effective values. Statistical analysis of the strain values was performed with Friedmantest, 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%; cubitusvarus 20°: 8.2%; cubitus varus 30°: 6.3%, P < 0.001). The control and cubitus valgus models had similar values, but thecubitus 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 cmproximal to the medial epicondyle was observed in the cubitus valgus model. Major changes may have beenobserved in the measurement behind the medial epicondyle. In the cubitus varus model, the ulnar nerve was relaxedduring 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
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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
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