Larson Brandon M, Shikhman Alex, Brown Meghan S, Tran Mike Q, Dietrich John W
Summa Health, Akron, OH, USA.
Crystal Clinic Orthopaedic Center, Akron, OH, USA.
Hand (N Y). 2025 Jan;20(1):65-70. doi: 10.1177/15589447231174043. Epub 2023 May 29.
Cubital tunnel syndrome (CuTS) is a lifestyle-altering peripheral neuropathy lacking a consensus for optimal surgical management. We describe creation of a fascial "V-sling" without ulnar nerve transposition, which is associated with increased surgical morbidity compared with decompression. The purpose of this study is to evaluate a novel technique with effective ulnar nerve decompression and subluxation prevention by creating a fascial sling in patients with CuTS and ulnar nerve subluxation.
We reviewed records of 39 elbows in 35 patients who underwent in situ ulnar nerve decompression and creation of a fascial sling in a "V" configuration to stabilize the nerve in its native position. We examined patient demographics, Single Assessment Numeric Evaluation (SANE) scores, Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores, and patient outcomes. Chi-square and student's test were used for all analysis.
A total of 37 extremities in 33 patients undergoing nerve decompression had nerve subluxation confirmed intraoperatively. There was a statistically significant change in preoperative and postoperative SANE scores of 64.5 and 82.3, respectively. Mean QuickDASH scores decreased significantly from 49.3 preoperative to 10.8 postoperative. The long-term QuickDASH scores obtained at mean of 564 days were maintained at 10.76.
This study describes a novel technique for treating CuTS by achieving in situ nerve decompression and addressing ulnar nerve subluxation with creation of an intermuscular septal sling. The technique improved functional outcomes and provided symptomatic relief, while avoiding risks commonly associated with nerve transposition.
肘管综合征（CuTS）是一种会改变生活方式的周围神经病变，对于最佳手术治疗方案尚无共识。我们描述了一种不进行尺神经转位的筋膜“V形吊带”的创建方法，与减压术相比，尺神经转位会增加手术发病率。本研究的目的是评估一种新技术，通过为患有CuTS和尺神经半脱位的患者创建筋膜吊带，实现有效的尺神经减压和预防半脱位。
我们回顾了35例患者39个肘部的记录，这些患者接受了原位尺神经减压并创建了“V”形筋膜吊带，以将神经稳定在其原始位置。我们检查了患者的人口统计学数据、单项评估数字评分（SANE）、手臂、肩部和手部快速残疾评估（QuickDASH）评分以及患者的治疗结果。所有分析均使用卡方检验和学生t检验。
在接受神经减压的33例患者中，共有37个肢体在术中证实存在神经半脱位。术前和术后SANE评分分别为64.5和82.3，有统计学意义的变化。平均QuickDASH评分从术前的49.3显著降低至术后的10.8。平均564天获得的长期QuickDASH评分维持在10.76。
本研究描述了一种治疗CuTS的新技术，通过实现原位神经减压并创建肌间隔吊带解决尺神经半脱位问题。该技术改善了功能结果并缓解了症状，同时避免了与神经转位相关的常见风险。
