Akins Xavier A, Javid Kashif, Will Catherine M, Meyers Amy L, Stone Austin V
Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, USA.
Cureus. 2024 Jul 31;16(7):e65854. doi: 10.7759/cureus.65854. eCollection 2024 Jul.
Ulnar neuropathy is one of the more commonly diagnosed mononeuropathies; despite this, a definitive surgical treatment strategy has not been widely agreed upon. In this study, we systematically review the literature and assess return to play or activity outcomes in patients with neuritis or neuropathy undergoing in situ decompression, subcutaneous transposition, or submuscular transposition of the ulnar nerve. We hypothesized that ulnar nerve transposition or decompression in the absence of concomitant ulnar collateral ligament (UCL) pathology would have a high rate of return to activity. Relevant studies were generated from 1975 to 2023 using PubMed, Academic Search Complete, CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE, and SPORTDiscus. Articles reporting on return to play or activity outcomes following isolated ulnar nerve transposition or decompression for ulnar neuritis were included. Studies evaluating patients with concomitant UCL injury or revision surgery were excluded. A total of 12 studies met the inclusion criteria, ranging from 1977 to 2021. There were a total of 358 patients with a reported return to play or activity status across all studies with an average age of 27.2 years (range, 11-75). Successful return to play, activity, or work was reported in 303 patients (84.6%). Patients undergoing transposition, subcutaneous (n = 232) and submuscular (n = 20), had return rates of 87.9% and 95%, respectively. Patients undergoing in situ decompression (n = 106) had return rates of 75.5%. This systematic review found an 84.6% return to activity rate following ulnar nerve transposition or decompression in the absence of concomitant UCL pathology. Overall, transposition or decompression of the ulnar nerve provides a favorable return to activity rates and with appropriate indications and surgical technique will likely yield a successful return.
尺神经病变是较常被诊断出的单神经病变之一；尽管如此，一种明确的外科治疗策略尚未得到广泛认可。在本研究中，我们系统地回顾了文献，并评估了接受尺神经原位减压、皮下移位或肌下移位的神经炎或神经病变患者恢复运动或活动的结果。我们假设，在不存在尺侧副韧带（UCL）病变的情况下，尺神经移位或减压会有较高的恢复活动率。使用PubMed、学术搜索完整版、护理学与健康相关文献累积索引（CINAHL）、医学期刊数据库（MEDLINE）和体育科学数据库（SPORTDiscus）检索了1975年至2023年的相关研究。纳入了报告单纯尺神经移位或减压治疗尺神经炎后恢复运动或活动结果的文章。排除了评估伴有UCL损伤或翻修手术患者的研究。共有12项研究符合纳入标准，时间跨度为1977年至2021年。所有研究中共有358例患者报告了恢复运动或活动的状态，平均年龄为27.2岁（范围为11 - 75岁）。303例患者（84.6%）报告成功恢复运动、活动或工作。接受移位手术的患者，皮下移位（n = 232）和肌下移位（n = 20）的恢复率分别为87.9%和95%。接受原位减压的患者（n = 106）恢复率为75.5%。这项系统评价发现，在不存在合并UCL病变的情况下，尺神经移位或减压后恢复活动率为84.6%。总体而言，尺神经移位或减压能带来良好的恢复活动率，在有适当指征和手术技术的情况下，可能会成功恢复。
