So Sang-Pil, Lee Won Sun, Ku KiHyeok, Shin Young Ho, Kim Jae Kwang
Department of Orthopedic Surgery, Armed Forces Capital Hospital, Seongnam-si, Gyeonggi-do, South Korea.
Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Republic of Korea.
PLoS One. 2025 Jan 29;20(1):e0318303. doi: 10.1371/journal.pone.0318303. eCollection 2025.
Cubital tunnel syndrome is a common peripheral neuropathy of the upper extremity. Anterior transposition of the ulnar nerve is an established surgical treatment option for this condition. This study aimed to introduce a novel musculofascial lengthening technique that uses only a portion of the flexor-pronator muscle mass for submuscular anterior transposition of the ulnar nerve and investigate its clinical outcomes.
We evaluated 28 patients (29 cases; 1 patient had bilateral involvement) diagnosed with cubital tunnel syndrome who were treated with surgical decompression and submuscular anterior transposition of the ulnar nerve using our novel technique. Mean follow-up was 19.1 months (range, 12-31). Patient-reported outcomes were assessed using the Boston Carpal Tunnel Questionnaire (BCTQ), Disabilities of the Arm, Shoulder, and Hand (DASH) Questionnaire, and numeric rating scale (NRS) for pain. Objective outcomes including light touch perception, static two-point discrimination, and grip strength were also assessed. Modified Bishop score and postoperative complications were also evaluated.
BCTQ symptom severity and functional status scores, DASH score, and NRS for pain score showed significant improvement after surgery. Light touch perception, static two-point discrimination, and grip strength also significantly improved after surgery. All patients showed excellent or good results according to the modified Bishop scoring system. No recurrence or complications occurred.
Our novel musculofascial lengthening technique that uses only a portion of the flexor-pronator muscle mass for submuscular anterior transposition of the ulnar nerve reliably achieves good results with minimal complications in patients with cubital tunnel syndrome.
肘管综合征是一种常见的上肢周围神经病变。尺神经前置术是针对该病症已确立的手术治疗选择。本研究旨在介绍一种新型的肌筋膜延长技术，该技术仅使用部分屈肌 - 旋前肌肌块进行尺神经肌下前置，并研究其临床效果。
我们评估了28例（29侧；1例为双侧患病）被诊断为肘管综合征的患者，这些患者采用我们的新技术接受了手术减压和尺神经肌下前置治疗。平均随访时间为19.1个月（范围12 - 31个月）。使用波士顿腕管问卷（BCTQ）、手臂、肩部和手部功能障碍（DASH）问卷以及疼痛数字评定量表（NRS）评估患者报告的结果。还评估了包括轻触觉、静态两点辨别觉和握力在内的客观结果。同时评估改良毕晓普评分和术后并发症。
术后BCTQ症状严重程度和功能状态评分、DASH评分以及疼痛NRS评分均有显著改善。术后轻触觉、静态两点辨别觉和握力也显著改善。根据改良毕晓普评分系统，所有患者均显示出优或良的结果。未发生复发或并发症。
我们的新型肌筋膜延长技术仅使用部分屈肌 - 旋前肌肌块进行尺神经肌下前置，在肘管综合征患者中能可靠地取得良好效果，且并发症最少。
