Li Chun-Wei, Wu John Chung-Han, Lan Ching-Yu, Lee Che-Hsiung, Huang Ren-Wen, Lin Cheng-Hung, Hsu Chung-Chen, Lin Yu-Te, Chen Shih-Hsien, Tang Yueh-Bih, Chen Hung-Chi, Chen Shih-Heng
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Taoyuan, Taiwan.
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Taoyuan, Taiwan; Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan.
Asian J Surg. 2023 Jan;46(1):180-186. doi: 10.1016/j.asjsur.2022.03.006. Epub 2022 Mar 17.
Ulnar tunnel syndrome (UTS) is relatively uncommon compared to the carpal tunnel or cubital tunnel syndromes. Few reports dedicated to the functional outcomes after surgical intervention of the UTS exist. Herein we compare the outcomes of patients with UTS of different etiologies.
Patients diagnosed with UTS between 2016 and 2020 were recruited. Ulnar tunnel release was performed in all patients, along with other necessary osteosynthesis or reconstructive procedures in the traumatic group. Patients were followed-up every six months post-operatively. Outcomes measured include: objective evaluations, subjective questionnaires, records of clinical signs, and grading of the British Medical Research Council scale for intrinsic muscle strength.
21 patients were recruited, and favorable results were noted in all of them after surgery. Traumatic UTS patients had a worse initial presentation than the non-traumatic cases, but had a greater improvement after surgery and yielded outcomes comparable with those of the patients without trauma. Patients with aberrant muscles in their wrists had better outcomes in some objective measurements than those without aberrant muscles.
Ulnar tunnel release improves the outcome of patients regardless of the etiology, especially in patients with trauma-induced UTS. Thus, a proper diagnosis of the UTS should be alerted in all patients encountering paresthesia in the ulnar digits, ulnar-sided pain, weakness of grip strength, or intrinsic weakness to ensure good outcomes.
与腕管综合征或肘管综合征相比，尺管综合征（UTS）相对不常见。关于UTS手术干预后功能结局的报道很少。在此，我们比较不同病因的UTS患者的结局。
招募2016年至2020年间诊断为UTS的患者。所有患者均进行尺管松解术，创伤组患者还进行其他必要的骨固定或重建手术。术后每六个月对患者进行随访。测量的结局包括：客观评估、主观问卷、临床体征记录以及英国医学研究委员会内在肌力量表评分。
共招募21例患者，术后所有患者均取得良好效果。创伤性UTS患者的初始表现比非创伤性患者差，但术后改善更大，其结局与非创伤患者相当。手腕部有异常肌肉的患者在一些客观测量中的结局比没有异常肌肉的患者更好。
无论病因如何，尺管松解术均可改善患者结局，尤其是创伤性UTS患者。因此，对于所有出现尺侧手指感觉异常、尺侧疼痛、握力减弱或内在肌无力的患者，均应警惕UTS的正确诊断，以确保良好结局。
