Lancigu R, Saint Cast Y, Raimbeau G, Rabarin F
Département de chirurgie osseuse, centre hospitalier universitaire, 4, rue Larrey, 49933 Angers cedex 9, France.
Centre de la main, 47, rue de la Foucaudière, 49800 Trélazé, France.
Chir Main. 2015 Oct;34(5):234-9. doi: 10.1016/j.main.2015.08.001. Epub 2015 Sep 7.
Anterior submuscular transposition of the ulnar nerve described by Dellon can solve the dynamic component of cubital tunnel syndrome at the elbow. We carried out a retrospective, single-surgeon study. The McGowan scale as modified by Goldberg (MG) was used preoperatively and at the final assessment; the QuickDASH was completed at the final assessment. The cohort comprised of 82 patients (38 females, 44 males) with a mean age of 61.2 years (37-92). The preoperative MG grade was: stage I (52%), IIA (28%), IIB (16%), III (4%). Three postoperative complications (3.5%) were recorded: two hematomas that did not require surgical revision and one case of elbow stiffness that resolved with physical therapy. Mean follow-up was 11.1 years (11-12). We identified 5 cases of confirmed recurrences (5.9%), 7 of secondary deterioration (8.5%) and 3 of initially poor result (3.5%). Sixty-six patients (86%) considered themselves cured at the final assessment. The MG scale at the last follow-up was: stage 0 (85.5%), I (9%), IIA (5%), III (0%). The QuickDASH was 11.88 (11-16). Mean time to recurrence was 6.3 years (1.5-10). Dellon's anterior submuscular transposition can be considered a reliable procedure. Eighty-six percent of patients were cured and 6% recurrence rate was noted. However, this is a demanding procedure.
由德隆描述的尺神经肌下前置术可解决肘部肘管综合征的动态因素。我们开展了一项单术者回顾性研究。术前及最终评估时采用经戈德堡修改的麦高恩量表(MG);最终评估时完成快速上肢功能障碍量表(QuickDASH)。该队列包括82例患者(38例女性,44例男性),平均年龄61.2岁(37 - 92岁)。术前MG分级为:I期(52%),IIA期(28%),IIB期(16%),III期(4%)。记录到3例术后并发症(3.5%):2例血肿,无需手术修复,1例肘关节僵硬,经物理治疗后缓解。平均随访时间为11.1年(11 - 12年)。我们确定有5例确诊复发(5.9%),7例继发恶化(8.5%),3例初始效果不佳(3.5%)。66例患者(86%)在最终评估时认为自己已治愈。最后一次随访时的MG量表分级为:0期(85.5%),I期(9%),IIA期(5%),III期(0%)。QuickDASH评分为11.88(11 - 16)。复发的平均时间为6.3年(1.5 - 10年)。德隆的肌下前置术可被认为是一种可靠的手术方法。86%的患者治愈,复发率为6%。然而,这是一种要求较高的手术。