Kang Ho-Jung, Koh Il-Hyun, Chun Yong-Min, Oh Won-Taek, Chung Kwang-Ho, Choi Yun-Rak
Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Yonseiro 50-1, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
J Orthop Surg Res. 2015 Aug 6;10:121. doi: 10.1186/s13018-015-0267-8.
The purpose of this study was to compare the clinical outcomes of ulnar nerve stability-based surgery via a small incision with those of classic anterior transposition of the ulnar nerve for cubital tunnel syndrome.
From March 2008 to December 2013, 107 patients with cubital tunnel syndrome underwent simple decompression or anterior transposition via a small incision, according to an ulnar nerve stability-based decision based on an assessment of intraoperative ulnar nerve stability (group A, n = 51), or anterior transposition via a classic incision (group B, n = 56). Clinical outcome was assessed using grip and pinch strength, two-point discrimination, the mean of the disabilities of arm, shoulder, and hand (DASH) survey, and the modified Bishop scale.
At the final follow-up, all outcome measures improved significantly in both groups and there were no significant differences between the two groups. However, there were fewer operation-related complications in group A (one revision surgery) than in group B (one superficial infection, two painful scars, and five cases of numbness at the medial elbow).
Outcomes after the ulnar nerve stability-based approach and anterior transposition were similar, although more patients experienced operation-related complications after anterior transposition via a classic incision. Making an ulnar nerve stability-based decision to perform either simple decompression or anterior transposition via a small incision seems to be a better strategy for patients with cubital tunnel syndrome.
本研究旨在比较基于尺神经稳定性的小切口手术与经典尺神经前置术治疗肘管综合征的临床疗效。
2008年3月至2013年12月，107例肘管综合征患者根据术中对尺神经稳定性的评估，基于尺神经稳定性决定接受单纯减压或小切口前置术（A组，n = 51），或经典切口前置术（B组，n = 56）。使用握力和捏力、两点辨别觉、上肢、肩部和手部功能障碍（DASH）量表平均分以及改良毕晓普量表评估临床疗效。
末次随访时，两组所有疗效指标均显著改善，两组间无显著差异。然而，A组（1例翻修手术）的手术相关并发症少于B组（1例表浅感染、2例疼痛性瘢痕和5例内肘麻木）。
基于尺神经稳定性的手术方法与前置术的疗效相似，尽管经典切口前置术后更多患者出现手术相关并发症。对于肘管综合征患者，基于尺神经稳定性决定行单纯减压或小切口前置术似乎是更好的策略。
