Struthers' arcadeにおける尺骨神経麻痺の症例

Ulnar Nerve Palsy Caused by the Struthers' Arcade : Case Report

　抄録：Struthers' arcadeによる尺骨神経麻痺の症例を経験した．症例は28歳，女性．初診時右尺骨神経支配領域に2/10の知覚鈍麻と筋力低下を認め，右上腕内側中央1/3の部位にTinel様徴候を認めた．単純X線像上異常はなく，筋電図で異常を認めた．Struthers' arcadeでの神経障害と考え手術を施行した．術後2点識別覚，筋萎縮は改善した．高位不明の尺骨神経麻痺にはStruthers' arcadeでの障害も念頭におき，同部位での近位，遠位で神経伝導速度を比較する必要があると思われた．

　We report a case of ulnar nerve paralysis caused by Struthers' arcade. The patient was a 28-year old woman, who developed 2/10 sensory disturbance and muscle weakness in the right ulnar nerve region, and a Tinel-like sign on the medial aspect of the distal third of the right arm. The plain X-ray findings were unremarkable, but abnormal findings were detected on electromyograms. We performed neuropathy in Struthers' arcade and thought operation. Postoperatively sensory two-point discrimination and muscle atrophy had improved . These observations demonstrated the importance of evaluation and comparison of nerve conduction above and below Struthers' arcade in consideration of ulnar nerve disturbance in cases of unknown paralysis of the upper nerve.