Spies Christian K, Schäfer Melanie, Langer Martin F, Bruckner Thomas, Müller Lars P, Unglaub Frank
Department of Hand Surgery, Vulpius Klinik, Vulpiusstraße 29, 74906, Bad Rappenau, Germany.
Medical Faculty Mannheim of the Ruprecht-Karls University Heidelberg, Theodor-Kutzer-Ufer 1 - 3, 68167, Mannheim, Germany.
Int Orthop. 2018 Jun;42(6):1331-1337. doi: 10.1007/s00264-018-3760-y. Epub 2018 Jan 16.
The aim of the study was to investigate functional and patient-rated outcome parameters after endoscopic assisted release of the ulnar nerve for cubital tunnel syndrome.
One hundred of 204 consecutive patients between 2006 and 2011 met the inclusion/exclusion criteria. Fifty-one of these patients were recruited and evaluated clinically and by questionnaire testing retrospectively after a mean follow-up of 82 months (range: 60-116).
Neurological parameters (two-point-discrimination, application of Semmes-Weinstein monofilaments, Tinel's test), grip, and three-point pinch strength were not significantly different from the contralateral extremity at the time of examination, whereas key pinch strength was significantly weaker. Mean Disabilities of the Arm, Shoulder, and Hand score was 20.82. Patients' overall opinion was good/excellent for 78% of the study population.
The examined surgical procedure proved to be as efficacious as open in-situ decompression regarding functional outcome with fewer post-operative complications. Regarding the results it might be postulated that grip strength and three-point pinch strength determination is not necessarily relevant for ulnar nerve evaluation.
Endoscopic assisted release of the ulnar nerve is a reliable and safe treatment option for cubital tunnel syndrome with satisfactory mid-to-long term functional and patient-rated outcomes.
本研究旨在调查内镜辅助下尺神经松解治疗肘管综合征后的功能及患者自评结局参数。
2006年至2011年间连续纳入的204例患者中，100例符合纳入/排除标准。其中51例患者被招募，并在平均随访82个月（范围：60 - 116个月）后进行回顾性临床评估和问卷调查。
检查时，神经学参数（两点辨别觉、Semmes-Weinstein单丝应用、Tinel试验）、握力和三点捏力与对侧肢体无显著差异，而关键捏力明显较弱。手臂、肩部和手部残疾程度平均评分为20.82。78%的研究人群对患者的总体评价为良好/优秀。
就功能结局而言，所检查的手术方法与开放原位减压一样有效，且术后并发症更少。根据结果推测，握力和三点捏力测定对尺神经评估不一定相关。
内镜辅助下尺神经松解术是治疗肘管综合征的一种可靠且安全的选择，具有令人满意的中长期功能及患者自评结局。
