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Kompressionssyndrome des N. ulnaris

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Book cover Nervenkompressionssyndrome

Zusammenfassung

Das Kubitaltunnelsyndrom ist als typische Lokalisation im Verlauf des N. ulnaris am Ellenbogen das zweithäufigste Kompressionssyndrom eines peripheren Nervs. Es liegt mit deutlichem Abstand hinter dem 10-mal häufigeren KTS und ist pathogenetisch nach wie vor nicht unumstritten, was sich auch an der uneinheitlichen Nomenklatur zeigt. Es wurde früher als Sulcus-nervi-ulnaris-Syndrom bezeichnet und ist in der neurologischen Nomenklatur unter dem Begriff UNE (Ulnaris-Neuropathie am Ellenbogen) bekannt. Mittlerweile ist die Ventralverlagerung des N. ulnaris in ihren verschiedenen Varianten (subkutan, submuskulär) mit nicht unerheblichen operativen Risiken weitgehend durch die einfache Dekompression verdrängt worden. Alternativ findet die minimale mediale Epikondylektomie ihre Befürworter. Endoskopische Verfahren sind zunehmend im Einsatz. Aufgrund der derzeitigen Studienlage ergeben sich hierdurch (in Analogie zum Karpaltunnelsyndrom) jedoch weder eindeutige Vor- noch Nachteile.

Eine seltene Kompressionsstelle findet sich am Handgelenk – als Loge-de-Guyon-Syndrom – bzw. eine noch weiter distal gelegene Kompression des Ramus profundus nervi ulnaris. Ursächlich kommen am häufigsten externe Druckparesen („Radfahrerlähmung“) mit guter Spontanprognose, aber auch operativ zu behandelnde Ganglienzysten oder andere Raumforderungen infrage.

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Notes

  1. 1.

    1 Autor Reimer Hoffmann/Oldenburg.

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Authors and Affiliations

  1. Neurochirurgische Klinik der Universität Ulm am Bezirkskrankenhaus Günzburg, Ludwig-Heilmeyer-Str. 2, 89312, Günzburg, Deutschland

    Gregor Antoniadis Prof. Dr.

  2. Abtsweg 13, 69198, Schriesheim, Deutschland

    Hans Assmus Dr. med.

  3. Institut für Handchirurgie und Plastische Chirurgie, HPC-Oldenburg, Marienstraße 1, 26121, Oldenburg, Deutschland

    Reimer Hoffmann Dr. med.

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  1. Hans Assmus Dr. med.
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  1. Schriesheim, Baden-Württemberg, Germany

    Hans Assmus

  2. Neurochirurgische Klinik der Universität Ulm am Bezirkskrankenhaus Günzburg, Günzburg, Germany

    Gregor Antoniadis

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Assmus, H., Antoniadis, G., Hoffmann, R. (2015). Kompressionssyndrome des N. ulnaris. In: Assmus, H., Antoniadis, G. (eds) Nervenkompressionssyndrome. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55212-0_8

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