Olaiya Oluwatobi R, Huynh Minh, Ebeye Tega, Gallo Lucas, Mbuagbaw Lawrence, McRae Matthew
Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Canada.
Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada.
Plast Surg (Oakv). 2025 Feb;33(1):68-77. doi: 10.1177/22925503231201631. Epub 2023 Sep 21.
It is unknown whether early mobilization after cubital tunnel decompression improves functional outcomes without increasing complication risks. This systematic review aims to evaluate the effectiveness of early mobilization compared to delayed mobilization of the elbow after ulnar nerve decompression. Randomized controlled trials (RCTs) and observational studies comparing adults who received early mobilization or late mobilization were included. Embase, MEDLINE, CENTRAL, PEDro, clinicaltrials.gov, and the World Health Organization database were systematically searched from inception to January 2023. Of the 2183 studies identified and screened, five studies (two RCT and three observational) totaling 224 patients (232 elbows) were included in this review. Evidence from two RCTs (100 patients) suggests that early mobilization may result in a large reduction in the amount of time needed to return to work (mean difference 40.1 days, 95% confidence interval [CI] 16-64 days earlier, = 85%, low-certainty evidence) and little to no difference in grip strength (0 kg, 95% CI = -0.17 to 0.17, = 0%, low-certainty evidence). There was little to no difference in adverse events or range of motion (low to very-low certainty evidence). Pooled results from the three observational studies showed similar findings (very low-certainty evidence). There were no studies that evaluated upper extremity related quality of life. Immobilizing patients for periods longer than 3 days appears to delay patient's return to work with no appreciable clinical benefit.
目前尚不清楚尺神经沟减压术后早期活动能否在不增加并发症风险的情况下改善功能结局。本系统评价旨在评估与尺神经减压术后延迟活动相比，早期活动的有效性。纳入比较接受早期活动或晚期活动的成年人的随机对照试验（RCT）和观察性研究。从建库至2023年1月，对Embase、MEDLINE、CENTRAL、PEDro、clinicaltrials.gov和世界卫生组织数据库进行了系统检索。在识别和筛选的2183项研究中，本评价纳入了5项研究（2项RCT和3项观察性研究），共224例患者（232个肘部）。两项RCT（100例患者）的证据表明，早期活动可能会大幅缩短恢复工作所需的时间（平均差异40.1天，95%置信区间[CI]提前16 - 64天，I² = 85%，低确定性证据），而握力几乎没有差异（0 kg，95% CI = -0.17至0.17，I² = 0%，低确定性证据）。不良事件或活动范围几乎没有差异（低至极低确定性证据）。三项观察性研究的汇总结果显示了类似的结果（极低确定性证据）。没有研究评估上肢相关生活质量。将患者固定超过3天似乎会延迟患者恢复工作，且没有明显的临床益处。
