Triceps Aşırı Kullanımına Bağlı Gelişen Spiral Oluk Tuzak Nöropatisi: Bir Olgu Sunumu

Spiral oluk tuzak nöropatisi, radial sinirin spiral oluk seviyesinde yüzeyel seyretmesinden dolayı çeşitli nedenlerle meydana gelebilen bir kompresyon nöropatisidir. Kompresyon nöropatisi gelişim mekanizmasında tekrarlayıcı hareketler rol oynadığı için triceps kasının zorlayıcı ve tekrarlayıcı hareketleri spiral oluk tuzak nöropatisine zemin hazırlayabilmektedir. Bu olguda uzun süreli çim biçme makinası kullanımı sonrasında düşük el gelişmiş 61 yaşında bir erkek hasta sunulmaktadır. Hasta kliniğimizde yapılan fizik muayene bulguları ve istenen elektronörofizyolojik test, manyetik rezonans görüntüleme sonucu spiral oluk tuzak nöropatisi tanısı almıştır. Hastanın motor ve duyu defisiti, verilen fizik tedavi ve akupunktur tedavisi sonucunda 6 hafta sonra tamamen iyileşti.

Anahtar Kelimeler:

radial sinir, Tuzak nöropatisi, Radial sinir nöropatisi

Spiral Groove Entrapment Neuropathy Due to Overuse of The Triceps: A Case Report

Spiral groove entrapment neuropathy is a compression neuropathy that can occur for various reasons due to the superficial course of the radial nerve at the level of the spiral groove. Since repetitive movements play a role in the development mechanism of compression neuropathy, compelling and repetitive movements of the triceps muscle may predispose to spiral groove entrapment neuropathy. In this case, a 61-year-old male patient who developed a low hand after long-term use of a lawnmower is presented. The patient was diagnosed with spiral groove entrapment neuropathy as a result of the physical examination findings performed in our clinic and the requested electroneurophysiological test, magnetic resonance imaging. The patient's motor and sensory deficit completely recovered after 6 weeks as a result of physical therapy and acupuncture treatment.

Keywords:

radial nerve, Entrapment neuropathy Radial nerve neuropathy, Tuzak nöropatisi, Radial sinir nöropatisi,

PDF

___

1. Bumbasirevic M, Palibrk T, Lesic A, Atkinson H. Radial nerve palsy. EFORT Open Rev. 2016 ;1:286-94.
2. Dong Q, Jacobson JA, Jamadar DA, et al. Entrapment neuropathies in the upper and lower limbs: anatomy and MRI features. Radiol Res Pract. 2012:230679.
3. Bodner G, Huber B, Schwabegger A, Lutz M, Waldenberger P. Sonographic detection of radial nerve entrapment within a humerus fracture. J Ultrasound Med. 1999 ;18:703-6.
4. Neal SJ, Fields KB. Peripheral nerve entrapment and injury in the upper extremity. Am Fam Physician. 2010;81:147–5.
5. Rempel DM, Diao E. Entrapment neuropathies: pathophysiology and pathogenesis. J Electromyogr Kinesiol. 2004;14:71–5.
6. Demiryürek B. E, Emre U, Demirel E. A, et al. Radial sinir nöropatilerinin retrospektif değerlendirilmesi. İstanbul Med J. 2015; 16: 116-8.
7. Chhabra A, Deune GE, Murano E, et al. Advanced MR neurography imaging of radial nerve entrapment at the spiral groove: a case report. J Reconstr Microsurg. 2012; 28: 263–266.
8. Lowe JB, Sen SK. Current approach to radial nerve paralysis. Plastic and Reconstructive Surgery. 2002; 110: 1099-112.
9. Öksüz Ç. Üst ekstremite tuzak nöropatilerinde rehabilitasyon. Totbid Dergisi. 2015; 14: 529-36.
10. Alba C. Therapist’s management of radial tunnel syndrome. In: Mackin EJ, Callahan AD, Skirven TM, Schneider LH, Osterman AL, Hunter JM, editors. Rehabilitation of the hand and upper extremity, 5th ed. St. Louis: Mosby; 2002 p.696–700.
11. Abrams RA, Ziets RJ, Lieber RL,et al. Anatomy of the radial nerve motor branches in the forearm. J Hand Surg Am.1997 ;22:232-7.
12. Güdemez E. Üst ekstremitelerde görülen periferik sinir kompresyon nöropatileri. Türk Aile Hekimleri Dergisi. 2007; 11: 5-12.
13. Verhaar J, Spaans F. Radial tunnel syndrome. An investigation of compression neuropathy as a possible cause. J Bone Joint Surg Am. 1991; 73: 539-44.
14. Bevelaqua AC, Hayter CL, Feinberg JH, Rodeo SA. Posterior interosseous neuropathy: electrodiagnostic evaluation. HSS J. 2012;8: 184-189.
15. Lo YL, Fook-Chong S, Leoh TH, et al. Rapid ultrasonographic diagnosis of radial entrapment neuropathy at the spiral groove. J Neurol Sci. 2008 ;271:75-9.
16. Furuta T, Okamoto Y, Tohno E, et al. Magnetic resonance microscopy imaging of posterior interosseous nerve palsy. Jpn J Radiol. 2009;27:41-44.
17. Hammert WC. Radial nerve palsy. Orthopaedic Knowledge Online Journal. http:// orthoportal.aaos.org/oko/article.aspx?article=OKO_HAN026. (date last accessed 6 July 2016.
18. Millea PJ. Acupuncture treatment of compression neuropathy of the radial nerve: a single case report of" Saturday Night Palsy". Journal of Alternative & Complementary Medicine. 2005; 11: 167-169.
19. Cleary CK. Management of radial tunnel syndrome: A therapist’s clinical perspective. J Hand Ther. 2006;19:186–91.
20. van den Ende KI, Steinmann SP. Radial tunnel syndrome. J Hand Surg Am. 2010;35:1004–6.
21. Ng AB, Borhan J, Ashton HR, Misra AN, Redfern DR. Radial nerve palsy in an elite bodybuilder. Br J Sports Med. 2003;37:185-6.