Göbel F, Musgrave D S, Vardakas D G, Vogt M T, Sotereanos D G
University of Pittsburgh, Department of Orthopaedic Surgery, PA 15213, USA.
Clin Orthop Relat Res. 2001 Dec(393):228-36. doi: 10.1097/00003086-200112000-00025.
Sixty-four patients (66 elbows) treated for refractory cubital tunnel syndrome had minimal medial epicondylectomy and in situ decompression to minimize the potential disadvantages of classic medial epicondylectomy. After a mean followup of 27 months results were excellent in 27 patients (44%), good in 23 patients (35%), fair in 10 patients (15%), and poor in four patients (6%). No ulnar nerve palsy, ulnar nerve subluxation, or medial elbow instability were seen. The main complaint of patients regarding the procedure was tenderness at the osteotomy site. The results show that minimal medial epicondylectomy and in situ decompression of the ulnar nerve is a safe and effective method to treat patients with cubital tunnel syndrome. This procedure minimizes the disadvantage of medial instability and recurrent symptoms attributable to nerve trauma after a classic medial epicondylectomy.
64例(66个肘关节)接受治疗的顽固性肘管综合征患者接受了微创内侧上髁切除术及原位减压术,以尽量减少经典内侧上髁切除术的潜在弊端。平均随访27个月后,27例患者(44%)效果极佳,23例患者(35%)效果良好,10例患者(15%)效果尚可,4例患者(6%)效果较差。未观察到尺神经麻痹、尺神经半脱位或内侧肘关节不稳。患者对该手术的主要抱怨是截骨部位压痛。结果表明,微创内侧上髁切除术及尺神经原位减压术是治疗肘管综合征患者的一种安全有效的方法。该手术最大限度地减少了经典内侧上髁切除术后内侧不稳和神经损伤所致复发症状的弊端。