Hu Tianyou, Bian Yujie, Zhou Tao, Wang Qiankun, Zhou Ding, He Liang, Wang Zifu, Zhou Hongxiang
Department of Hand and Microsurgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
Department of Hand and Microsurgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
World Neurosurg. 2025 May;197:123885. doi: 10.1016/j.wneu.2025.123885. Epub 2025 Mar 17.
To evaluate the effect of intraoperative dexamethasone on short-term clinical outcomes following decompression procedures for cubital tunnel syndrome (CuTS) and its role in controlling postoperative inflammation.
A retrospective analysis was conducted on 114 patients with severe CuTS, categorized into a dexamethasone group (n=55) and a control group (n=59). All patients underwent anterior ulnar nerve transposition. The dexamethasone group received 10 mg of dexamethasone injected subepineurally after decompression. Outcomes were assessed at 4 weeks and 6 months postoperatively using visual analog scale, patient-reported ulnar nerve evaluation, Modified Bishop score, two-point discrimination, and electromyography.
At 4 weeks, the dexamethasone group showed significantly better improvements in visual analog scale (3.56 ± 0.88 vs. 4.03 ± 0.99, P = 0.014), patient-reported ulnar nerve evaluation (40.87 ± 7.82 vs. 43.49 ± 7.16, P = 0.045), and Bishop scores (8.69 ± 1.18 vs. 7.49 ± 0.88, P < 0.001) compared to the control group. Electrophysiological testing at 6 months also revealed higher motor nerve conduction velocity (50.04 ± 3.92 vs. 46.49 ± 4.84 m/s, P < 0.001) and sensory nerve conduction velocity (49.06 ± 4.60 vs. 47.10 ± 5.63 m/s, P = 0.041) in the dexamethasone group. No adverse effects were observed.
Intraoperative dexamethasone effectively reduces inflammation and edema, promoting early nerve recovery and improved short-term outcomes in CuTS decompression. It is a safe and effective adjunctive treatment strategy.
评估术中地塞米松对肘管综合征（CuTS）减压术后短期临床结局的影响及其在控制术后炎症中的作用。
对114例重度CuTS患者进行回顾性分析，分为地塞米松组（n = 55）和对照组（n = 59）。所有患者均接受尺神经前置术。地塞米松组在减压后经神经外膜下注射10 mg地塞米松。术后4周和6个月使用视觉模拟量表、患者报告的尺神经评估、改良毕晓普评分、两点辨别觉和肌电图评估结局。
在4周时，与对照组相比，地塞米松组在视觉模拟量表（3.56±0.88对4.03±0.99，P = 0.014）、患者报告的尺神经评估（40.87±7.82对43.49±7.16，P = 0.045）和毕晓普评分（8.69±1.18对7.49±0.88，P < 0.001）方面有显著更好的改善。6个月时的电生理测试还显示，地塞米松组的运动神经传导速度（50.04±3.92对46.49±4.84 m/s，P < 0.001）和感觉神经传导速度（49.06±4.60对47.10±5.63 m/s，P = 0.041）更高。未观察到不良反应。
术中地塞米松可有效减轻炎症和水肿，促进CuTS减压术后神经早期恢复并改善短期结局。它是一种安全有效的辅助治疗策略。
