주관 증후군: 최근 치료 동향 = Cubital Tunnel Syndrome: Recent Trends of Treatment

다국어 초록 (Multilingual Abstract)

Cubital tunnel syndrome is the second most common nerve entrapment syndrome affecting the upper extremity. Surgical treatment is indicated for those who have motor weakness or when conservative measures have failed. Several different surgical techniques have been introduced, however, the optimal treatment for cubital tunnel syndrome is still under debate. In the recent years, well-performed prospective randomized studies show that there is no difference in outcome among various surgical techniques regardless of the severity and presence of subluxation. It is advised that in situ decompression is the preferred technique because it is simpler and less time consuming procedure. Although in situ decompression is effective in uncomplicated ulnar nerve subluxation, anterior transposition should be considered when the subluxation is painful or when the ulnar nerve actually snaps back and forth over the medial epicondyle. Anterior transposition of the ulnar nerve is still indicated for revision surgery, previous trauma around the elbow, distal humerus fractures, severe osteoarthritis needing medial spur excision, and severe valgus deformity of the elbow.

국문 초록 (Abstract)

주관 증후군은 상지에서 수근관 증후군 다음으로 흔하게 발생하는 압박성 신경병증으로 주관절 내상과 주위에서 척골 신경이 눌려 발생한다. 다양한 수술적 치료 방법이 소개되고 있으나 어떤 수술적 방법이 가장 이상적인가에 대해서는 아직까지 논란이 있다. 최근의 전향적 무작위 연구 결과를 종합해 볼 때, 척골 신경 비전위 감압술을 시행하는 것만으로도 임상적으로 만족할 만한 결과를 얻을 수 있으며, 전방 이전술을 시행한 경우와 비교하여 결과에 차이가 없음이 밝혀지고 있다. 단, 척골 신경의아탈구나 탈구가 통증을 유발할 경우에는 척골 신경 전방 이전술을 시행하여야 하며,재수술인 경우나 주관절 내측에 외상의 과거력이 있는 경우, 원위 상완골 골절이 동반된 경우, 주관절의 심한 관절염으로 관절 절제술이 필요한 경우, 주관절의 심한 외반 변형이 있는 경우에는 척골 신경 전방 이전술이 필요하다.

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