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尺神经内镜松解术:前60例病例的回顾性评估

Endoscopic neurolysis of the ulnar nerve: retrospective evaluation of the first 60 cases.

作者信息

Sautier Etienne, Neri Thomas, Gresta Giorgio, Philippot Remi, Farizon Frederic

机构信息

Orthopaedic Surgery, University Hospital of Saint Etienne, Saint-Priest en Jarez, France.

Orthopaedic Surgery, University Hospital of Saint Etienne, Saint-Priest en Jarez, France; Physiology Laboratory, EA 4338, University Hospital of Saint Etienne, Saint-Étienne, France.

出版信息

J Shoulder Elbow Surg. 2017 Jun;26(6):1037-1043. doi: 10.1016/j.jse.2016.11.042. Epub 2017 Feb 2.

Abstract

BACKGROUND

The aim of this study was to determine the clinical efficacy of minimally invasive endoscopic ulnar nerve release at midterm follow-up.

METHODS

This was a retrospective, consecutive, single-center study. The inclusion criterion was presentation of the patient with isolated and stable cubital tunnel syndrome. The surgical technique described by Hoffmann and Siemionow in 2006 was used for all patients. The cubital tunnel syndrome was graded by Dellon's classification and scored as described by MacDermid and Grewal in 2013.

RESULTS

Sixty patients underwent surgery (62 cubital tunnel operations). Fifty-three patients were included in the study. The mean follow-up was 17 months (6-34). In the preoperative period, according to Dellon's classification, 8 patients were grade 1, 29 patients were grade 2, and 16 patients were grade 3. After surgery, according to the MacDermid score, 45 patients (84.9%) had good or excellent results, 6 (11.3%) had moderate results, and 2 (3.8%) had poor results. The mean preoperative score was 103.1 (25-181), and the mean postoperative score was 26.3 (0-135). By comparison with standard surgical technique, the endoscopic technique appears to be reliable with a similar success rate and functional improvement. The advantages are the minimally invasive portion of the surgical technique. Endoscopic control allowed complete release of the ulnar nerve with few complications.

CONCLUSION

The endoscopic technique as described by Hoffman et al had similar efficacy to open surgical techniques with the advantage of being minimally invasive.

摘要

背景

本研究的目的是确定微创内镜下尺神经松解术在中期随访时的临床疗效。

方法

这是一项回顾性、连续性、单中心研究。纳入标准为患者表现为孤立性且稳定的肘管综合征。所有患者均采用霍夫曼和西梅奥诺夫在2006年描述的手术技术。肘管综合征采用德龙分类法进行分级,并按照麦克德米德和格雷瓦尔在2013年描述的方法进行评分。

结果

60例患者接受了手术(62次肘管手术)。53例患者纳入研究。平均随访时间为17个月(6 - 34个月)。术前,根据德龙分类法,8例为1级,29例为2级,16例为3级。术后,根据麦克德米德评分,45例(84.9%)结果良好或优秀,6例(11.3%)结果中等,2例(3.8%)结果较差。术前平均评分为103.1(25 - 181),术后平均评分为26.3(0 - 135)。与标准手术技术相比,内镜技术似乎可靠,成功率和功能改善相似。其优点是手术技术的微创性。内镜控制可实现尺神经的完全松解,并发症较少。

结论

霍夫曼等人描述的内镜技术与开放手术技术疗效相似,具有微创的优势。

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