| The second most common peripheral nerve compressive neuropathy, cubital tunnel syndrome has unique features clinically and anatomically which make it a more challenging problem to deal with. |
肘管综合征是第二常见的周围神经压迫性神经病变，其在临床和解剖学上独特的特征使其成为更具挑战性的难题。 |
| From the standpoint of surgical intervention there are minimalists who favor in situ decompression and there are are those who might be characterized as traditionalists who favor submuscular transposition. |
单从手术干预的角度来谈，有极简主义者支持采用原位松解；有被认为是传统主义者的，支持肌下尺神经前置； |
| The other options are intermediate, consisting of epicondylectomy, anterior subcutaneous transposition, usually accompanied by a fascial sling. |
也有一些居中的选择——肱骨内上髁切除和皮下尺神经前置的组合，通常附加筋膜悬带； |
| Then there is the hybrid operation of sort which is referred to as an intramuscular transposition in which rotated flaps of muscle fascia form the roof of the tunnel, the floor is the fleshy muscle bellies left attached, while fibrous bands that might produce kinking or compression of the nerve within the muscular bed are released. |
最后一种是被称为肌内前置术的混合术式，该术式中，翻转的肌肉筋膜皮瓣形成肘管的顶部，肘管的底部是左侧附带的肉质肌腹，将可能扭曲或压缩肌层内神经的纤维束松解脱出来。 |
| With all the transposition options it has become customary to excise the distal aspect of the medial intermuscular septum. |
以上复位手术中，惯例是切除内侧肌间隔的远侧面， |
| This tissue may be left attached distally and use to augment a fascial sling for a subcutaneous transposition, or the fascial roof of a submuscular or intramuscular transposition. |
该组织可能左侧远端附着，用于在皮下前置术中增加筋膜悬带，或在肌内或肌内前置术中增扩筋膜顶部。 |
| When the flexor pronator origin is taken down it is desirable to reconstruct in a fashion that will allow for early motion at least through a limited arc to promote gliding of the nerve in its new bed and to avert stiffness in the elbow. |
屈肌旋前圆肌起点被取下后，有望至少通过限制弧度的早期运动进行重建，以促进神经在新神经床的滑动并避免肘部的僵硬。 |
| From the standpoint of diagnostic criteria and surgical intervention there are those who contend that unless there are electical studies to document the problem then it is not cubital tunnel syndrome and certainly not a problem to be addressed by surgical intervention to decompress the ulnar nerve. |
结合诊断标准和手术干预的角度，有些人认为，除非通过电生理研究可以证明，否则就不属于肘管综合征，当然也不适用手术干预减压尺神经。 |
| From the standpoint of pathophysiology there are those who consider this a nerve compression and those who emphasize the importance of local strain as a potential souce for symptoms. |
病理生理学角度来说，有些人认为这是神经压迫症，也有人强调局部应变作为症状潜在源的重要性。 |
| In the latter case, this is considered an additional rationale for anterior transposition over any method which may leave the nerve posterior to the flexion axis of the elbow where it will remain subject to more strain. |
后者被认为是肌下前置术的附加理论原理——能使尺神经留在肘屈曲轴后方，而肘部仍然能承受更多张力和拉力。 |
| Causation with regard to work relatedness can be controversial and especially in cases wherein electrodiagnostic studies are negative but symptoms severe. |
职业相关性作为病因是有争议的，尤其是在电反应诊断研究为阴性但症状严重的情况下。 |
| A contentious situation can arise leading to protracted work loss and litigation. |
有争议的情况可能会导致长期的工作损失和诉讼。 |
| The situation is more difficult because an appropriately cautious surgeon will be reticent to embark upon surgical intervention in the absence of objective verification in the form of an abnormal electical study. |
而一位一般谨慎的外科医生都会在缺乏异常电生理研究作为客观验证的情况下默认开展外科手术干预，导致形势更加不容乐观。 |
| The prudent surgeon will recognize that surgery for cubital tunnel has a mixed track record for success. |
任何一位审慎的外科医生会承认，肘管手术已有的战绩胜负参半。 |
| In the event of an unsatisfactory outcome with surgical intervention followup electordiagnostic studies and likely and not unexpectedly may indeed show changes after a surgery where none were present before. |
在一个手术结果不理想的事件中，手术干预的随访、电反应诊断研究非常可能且毫无意外地会发现，手术后的确会出现以前没有过的变化， |
| This is liable to be characterized as an iatrogenic worsening of the condition. |
这非常可能被认为是医源性疾病恶化。 |
| Despite this and other hazards having to do with the medico-legal and social issues surrounding the problem, it is widely held that early surgical intervention for cubital tunnel is associated with a more favorable outcome than late surgery. |
除却围绕该问题产生的医疗法律和社会问题方面诸如此类的风险，大家仍然广泛认为，针对肘管隧道的早期手术干预，与晚期手术相比具有更有利的结果。 |
| Ultimately insight in patient selection in conjunction with sound technique will allow successful navigation of these hazards. |
最终，对患者选择的洞察力结合健全的技术将成功避开这些风险。 |
