Department of Orthopedics, Yancheng No. 1 People's Hospital, Yancheng 224001, Jiangsu Province, China.
Department of Orthopedics, Yancheng No. 1 People's Hospital, Yancheng 224001, Jiangsu Province, China.
Hand Surg Rehabil. 2022 Jun;41(3):370-376. doi: 10.1016/j.hansur.2022.02.011. Epub 2022 Mar 11.
We aimed to explore the clinical efficacy of decompression and anterior transposition of the ulnar nerve in osteoarthritis-induced cubital tunnel syndrome (CTS). 109 patients with moderate-to-severe CTS treated from July 2015 to March 2019 were selected. Upper-limb function was scored. After ultrasound examination, decompression and anterior transposition of the ulnar nerve were performed; then ulnar nerve motor nerve conduction velocity (MNCV) was assessed. Patients were followed up every 3 months for 18 months and their prognosis was assessed. Upper-limb function examination results were compared according to disease severity. Univariate and multivariate regression analyses were conducted, and a nomogram prediction model was established. After treatment, the number of patients with intrinsic contracture of the hand, Tinel sign (+), clipping paper test (+) and Froment's sign (+) significantly declined; hand grip strength, ulnar nerve MNCV, latency, amplitude, 2-point discrimination (2-PD) and Disabilities of the Arm, Shoulder and Hand (DASH) score were improved (p < 0.05). Age, gender, course of disease, long-term elbow bend work (LTEBW), ulnar nerve MNCV, 2-PD and DASH score were independent risk factors for poor prognosis (p < 0.05). The calibration curve confirmed that prognosis results after treatment were highly consistent with actual outcomes. Decompression and anterior transposition of the ulnar nerve exerted significant therapeutic effects on moderate-to-severe osteoarthritis-induced CTS. The nomogram prediction model established by age, gender, course of disease, LTEBW, ulnar nerve MNCV, 2-PD and DASH score can be used to effectively evaluate prognosis.
我们旨在探索尺神经减压和前置术治疗骨关节炎引起的肘管综合征(CTS)的临床疗效。选取 2015 年 7 月至 2019 年 3 月收治的 109 例中重度 CTS 患者,上肢功能评分,超声检查后行尺神经减压和前置术,评估尺神经运动神经传导速度(MNCV),随访 18 个月,评估预后。根据疾病严重程度比较上肢功能检查结果。进行单因素和多因素回归分析,并建立预测模型。治疗后,手部内在挛缩、Tinel 征(+)、夹纸试验(+)和 Froment 征(+)的患者数量明显减少;手抓握力、尺神经 MNCV、潜伏期、振幅、2 点辨别觉(2-PD)和上肢功能、肩部和手部残疾(DASH)评分均改善(p<0.05)。年龄、性别、病程、长期肘弯曲工作(LTEBW)、尺神经 MNCV、2-PD 和 DASH 评分是预后不良的独立危险因素(p<0.05)。校准曲线证实治疗后预后结果与实际结果高度一致。尺神经减压和前置术对中重度骨关节炎引起的 CTS 具有显著的治疗效果。通过年龄、性别、病程、LTEBW、尺神经 MNCV、2-PD 和 DASH 评分建立的预测模型可以有效评估预后。