Clinical diagnosis and treatment of hourglass-like constrictions of peripheral nerve in the upper extremity

Abstract

Objective To discuss the clinical diagnosis and treatment of hourglass-like peripheral nerve constriction. Methods From January 2011 to April 2017, 9 cases of hourglass-like constrictions of peripheral nerve in the upper extremity were treated in our department. The clinical characteristics, ultrasound findings, treatment course and functional recovery were retrospectively analyzed. Results Single or multiple hourglass-like constrictions were found in 7 cases from 8 cases who underwent ultrasound examination. Location, quantity, degree of constriction and morphological changes of the involved nerve were consistent with what were seen during the operation. According to the degree of constriction, electrophysiological results and intraoperative findings, functional recovery benefited from the positive surgical treatment. There was no recovery in 1 case without ultrasound examination even 3 years after the operation. Conclusion The presence, location, quantity and narrow degree of hourglass-like constriction can be identified by ultrasound, which provides the basis for the formulation of individual surgical procedures to prevent the omission of the disease. However, it is related to the technical level and experience of the examiners. Active surgical intervention for the cases with severe hourglass-like constriction can promote the recovery of nerve function. Key words: Ultrasonography; Surgical procedures,operative; Hourglass-like constriction; Spontaneous peripheral nerve palsy