Leite José Alberto Dias, Sampaio Antônio Carlos Delgado, Leite Claudio Manoel Gonçalves da Silva, Leite Janaina Gonçalves da Silva, Sampaio Marina Vasconcelos, Lima Diego Ariel de
Departamento de Cirurgia, Universidade Federal do Ceará, Fortaleza, CE, Brasil.
Federal Rural do Semi-Árido (UFERSA), Mossoró, RN, Brasil.
Rev Bras Ortop (Sao Paulo). 2022 Feb 15;58(1):114-120. doi: 10.1055/s-0042-1742623. eCollection 2023 Feb.
To better characterize the role of endoscopic cubital tunnel release in leprosy neuritis and determine whether there is an improvement in pain, sensitivity, and strength with the use of this minimally invasive technique. A total of 44 endoscopic procedures for ulnar nerve decompression at the elbow were performed in patients who were previously diagnosed with leprosy neuritis. The inclusion criteria were surgical indication for ulnar nerve release and clinical treatment failure for 4 weeks in patients with cubital tunnel syndrome who had their ulnar nerve function, whether motor or sensitive, deteriorated progressively despite the treatment with prednisone 1 mg/kg/day and physiotherapy. For endoscopic release, the CTS Relief Kit (Linvatec. Largo, FL, USA) and a standard 4mm 30° arthroscope were used. The study included 39 patients, 29 (74.4%) males and 10 (25.6%) females. The age of the patients ranged from 12 to 64 years (33 ± 14.97). Five patients underwent bilateral release. The release demonstrated a statistically significant improvement in pain ( 0.002), in sensitivity ( < 0.001), and in strength ( < 0.001). The best results were obtained when ulnar release was performed less than 6 months after surgery indication. None of the procedures were converted from endoscopic to open. No major complications (infection, vascular injury, and nervous injury) were reported. One patient had ulnar nerve subluxation. The endoscopic release of the ulnar nerve at the elbow in leprosy neuritis entails true and safe benefits for the patient, such as improvement in pain, sensitivity and strength.
为了更好地描述内镜下肘管松解术在麻风神经炎中的作用，并确定使用这种微创技术后疼痛、感觉和力量是否有所改善。
对先前诊断为麻风神经炎的患者共进行了44例肘部尺神经减压的内镜手术。纳入标准为尺神经松解的手术指征，以及患有肘管综合征的患者，尽管接受了1mg/kg/天的泼尼松治疗和物理治疗，但尺神经功能（无论是运动功能还是感觉功能）仍逐渐恶化，临床治疗4周失败。对于内镜松解，使用了CTS Relief Kit（美国佛罗里达州拉戈市的Linvatec公司）和标准的4mm 30°关节镜。
该研究包括39例患者，其中男性29例（74.4%），女性10例（25.6%）。患者年龄在12至64岁之间（33±14.97）。5例患者接受了双侧松解。松解术后疼痛（P<0.002）、感觉（P<0.001）和力量（P<0.001）均有统计学意义的改善。手术指征后不到6个月进行尺神经松解时效果最佳。所有手术均未从内镜手术转为开放手术。未报告重大并发症（感染、血管损伤和神经损伤）。1例患者出现尺神经半脱位。
内镜下肘管尺神经松解术对麻风神经炎患者具有真正且安全的益处，如疼痛、感觉和力量的改善。
