Sousa Marco, Aido Ricardo, Trigueiros Miguel, Lemos Rui, Silva César
Departamento de Ortopedia e Traumatologia, Centro Hospitalar do Porto, Porto, Portugal.
Rev Bras Ortop. 2014 Oct 22;49(6):647-52. doi: 10.1016/j.rboe.2014.10.005. eCollection 2014 Nov-Dec.
To compare the results from two of the most commonly used surgical techniques: in situ decompression and subcutaneous transposition. The processes of patients treated surgically in a public university hospital between January 2004 and December 2011 were reviewed. Cases of proximal compression of the nerve, angular deformity of the elbow and systemic diseases associated with non-compressive neuropathy were excluded.
Ninety-seven cases were included (96 patients). According to the modified McGowan score, 14.4% of the patients presented grade Ia, 27.8% grade II, 26.8% grade IIb and 30.9% grade III. In situ neurolysis of the cubital was performed in 64 cases and subcutaneous anterior transposition in 33.
According to the modified Wilson and Knout score, the results were excellent in 49.5%, good in 18.6%, only satisfactory in 17.5% and poor in 14.4%. In comparing the two techniques, we observed similar numbers of excellent and good results. Grades IIb and III were associated with more results that were less satisfactory or poor, independent of the surgical technique.
Both techniques were shown to be efficient and safe for treating cubital tunnel syndrome.
比较两种最常用的手术技术(原位减压和皮下移位)的效果。回顾了2004年1月至2011年12月间在一所公立大学医院接受手术治疗的患者的病历。排除神经近端受压、肘部角畸形以及与非压迫性神经病变相关的全身性疾病的病例。
纳入97例(96名患者)。根据改良的麦高恩评分,14.4%的患者为Ia级,27.8%为II级,26.8%为IIb级,30.9%为III级。64例行肘部原位神经松解术,33例行皮下前路移位术。
根据改良的威尔逊和克努特评分,结果优秀的占49.5%,良好的占18.6%,一般的占17.5%,差的占14.4%。比较这两种技术,我们观察到优秀和良好结果的数量相似。IIb级和III级与更多不太满意或差的结果相关,与手术技术无关。
两种技术在治疗肘管综合征方面均显示出有效且安全。