Efstathopoulos Dimitrios G, Themistocleous George S, Papagelopoulos Panayiotis J, Chloros George D, Gerostathopoulos Nikolaos E, Soucacos Panayotis N
Department of Hand Surgery, KAT Hospital, Kifissia, Greece.
Clin Orthop Relat Res. 2006 Mar;444:134-9. doi: 10.1097/01.blo.0000201153.36948.29.
Partial medial epicondylectomy aims to eliminate potential drawbacks of total epicondylectomy for treatment of cubital tunnel syndrome. In this series, we retrospectively evaluated 80 patients (80 elbows) who had partial medial epicondylectomies for established cubital tunnel syndrome. Our main purpose was to compare clinical outcomes among partial, minimal, and total epicondylectomies. Specific attention was given to the functional outcome in severely impaired patients, and potential postoperative complications of total epicondylectomy, such as elbow instability, and medial elbow pain. Preoperatively, 16 patients were classified as having McGowan Grade I lesions, 40 had Grade II lesions, and 24 had Grade III lesions. The mean followup was 32 months (range, 26 months-4.2 years). There was improvement of at least one McGowan grade in 86.2% of the patients, with a 66.7% improvement in severely impaired patients (McGowan Grade III lesions). There was no ulnar nerve palsy, no ulnar nerve subluxation, or medial elbow instability. However, 45% of patients reported mild pain at the 6-month followup. Partial medial epicondylectomy seems to be safe and reliable for treatment of cubital compression neuropathy at the elbow.
Therapeutic study, Level IV (case series). See the Guidelines for Authors for a complete description of levels of evidence.
部分内侧上髁切除术旨在消除全上髁切除术治疗肘管综合征的潜在弊端。在本系列研究中，我们回顾性评估了80例因确诊肘管综合征而接受部分内侧上髁切除术的患者（80个肘部）。我们的主要目的是比较部分、最小及全上髁切除术的临床结果。特别关注了严重受损患者的功能结果以及全上髁切除术潜在的术后并发症，如肘关节不稳定和内侧肘部疼痛。术前，16例患者被归类为麦高恩I级病变，40例为II级病变，24例为III级病变。平均随访时间为32个月（范围为26个月至4.2年）。86.2%的患者至少有一个麦高恩分级得到改善，严重受损患者（麦高恩III级病变）的改善率为66.7%。未出现尺神经麻痹、尺神经半脱位或内侧肘关节不稳定情况。然而，45%的患者在6个月随访时报告有轻度疼痛。部分内侧上髁切除术治疗肘部尺神经卡压性神经病变似乎安全可靠。
治疗性研究；IV级（病例系列）。有关证据级别的完整描述，请参阅《作者指南》。
