Soltani Ali M, Best Matthew J, Francis Cameron S, Allan Bassan J, Panthaki Zubin J
Department of Surgery, Division of Plastic, Aesthetic, and Reconstructive Surgery, University of Miami, Miller School of Medicine, Miami, FL, USA.
J Hand Surg Am. 2013 Aug;38(8):1551-6. doi: 10.1016/j.jhsa.2013.04.044. Epub 2013 Jul 3.
To ascertain trends in the surgical treatment of ulnar nerve compression at the elbow within the United States.
We analyzed the National Survey of Ambulatory Surgery to study trends in the treatment of cubital tunnel syndrome from 1994 to 2006. The National Survey of Ambulatory Surgery provides a comprehensive overview of ambulatory surgical procedures performed in the United States. Patients identified in the database with surgically treated cubital tunnel syndrome were verified by members of our research staff and compiled into these 3 groups: decompression, transposition, and other. The data were then statistically analyzed for trends in treatment, utilization, and demographics.
A total of 52,133 surgical procedures were recorded in the National Survey of Ambulatory Surgery for the treatment of ulnar nerve compression in 2006. This represents an increase from 26,283 in 1994 and 35,406 in 1996. In the 11 years from 1996 to 2006, the total surgical procedures on the ulnar nerve increased by 47%. Transposition went from 49% of all cubital tunnel procedures in the 1990s to 38% in 2006. In 2006, women were much more likely to have a simple decompression (70%) than a transposition or other technique. Decompression had a mean surgical time of 48 minutes, and transposition had a mean surgical time of 59 minutes.
The percentage of transpositions used in the treatment of cubital syndrome has decreased to 37% in the last survey. Possible reasons include expanded indications or changing surgical preferences.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II.
确定美国肘部尺神经受压手术治疗的趋势。
我们分析了国家门诊手术调查，以研究1994年至2006年肘管综合征的治疗趋势。国家门诊手术调查全面概述了美国进行的门诊手术程序。我们的研究人员对数据库中确定接受手术治疗的肘管综合征患者进行了核实，并将其编入以下3组：减压、转位和其他。然后对数据进行统计分析，以了解治疗、利用和人口统计学方面的趋势。
2006年国家门诊手术调查记录了总共52,133例用于治疗尺神经受压的手术程序。这一数字高于1994年的26,283例和1996年的35,406例。在1996年至2006年的11年中，尺神经的总手术程序增加了47%。转位手术在20世纪90年代占所有肘管手术的49%，到2006年降至38%。2006年，女性接受单纯减压手术（70%）的可能性远高于转位或其他技术。减压手术的平均时间为48分钟，转位手术的平均时间为59分钟。
在上次调查中，用于治疗肘管综合征的转位手术比例已降至37%。可能的原因包括适应证扩大或手术偏好改变。
研究类型/证据水平：预后II级。
