Keith Jerrod, Wollstein Ronit
Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Pittsburgh Medical Center, PA, USA.
Ann Plast Surg. 2011 Jun;66(6):637-9. doi: 10.1097/SAP.0b013e318219183d.
Multiple studies have compared the outcome of surgery for cubital tunnel syndrome (CUTS), yet there remains no clear guidelines for treatment. We describe an approach to CUTS that includes tailoring the procedure to the pathology found at surgery. Patients treated surgically were retrospectively reviewed. Following in situ neurolysis, nerve stability within the cubital tunnel was assessed, and the nerve was left in situ, or transposed accordingly. We evaluated demographic information, presenting features, intraoperative and postoperative findings. Statistics included paired t test and logistic regression analysis. A total of 63 patients (standard deviation = 10.3 years) were reviewed. Fourteen nerves were transposed (22.5%). Postoperatively, sensation (71%), static 2-point discrimination, and motor strength improved. Grip strength compared with the uninvolved side was 94.8% postoperatively. Overall, 90% of the patients reported improvement in function. Our results compare favorably with other studies. Since CUTS originates from numerous causes, basing the operative plan on intraoperative findings produces excellent results.
多项研究对尺神经沟综合征(CUTS)的手术结果进行了比较,但对于治疗仍没有明确的指导方针。我们描述了一种针对CUTS的治疗方法,该方法包括根据手术中发现的病理情况调整手术方式。对接受手术治疗的患者进行了回顾性研究。在进行原位神经松解后,评估尺神经沟内神经的稳定性,并将神经留在原位或相应地进行移位。我们评估了人口统计学信息、临床表现、术中及术后发现。统计学分析包括配对t检验和逻辑回归分析。共回顾了63例患者(标准差 = 10.3岁)。14条神经进行了移位(22.5%)。术后,感觉(71%)、静态两点辨别觉和运动力量均有所改善。与未受累侧相比,术后握力为94.8%。总体而言,90%的患者报告功能有所改善。我们的结果与其他研究相比具有优势。由于CUTS有多种病因,根据术中发现制定手术方案可产生优异的结果。