Greco A, Marcovici L L, Molayem I, Amendola C, Pagnotta A
Jewish Hospital of Rome, Rome, Italy.
Sapienza University of Rome, Rome, Italy.
Musculoskelet Surg. 2025 Jul 31. doi: 10.1007/s12306-025-00916-7.
Ulnar nerve entrapment is a common condition, with a recurrence rate after surgery reaching up to 25%. In such cases, treatment remains controversial. During elbow surgery, management of the ulnar nerve and performing neurolysis are often the initial steps, even in the absence of clear symptoms. In this study, we assessed the clinical applicability of using an adipofascial flap to cover the nerve during elbow surgery.
A retrospective study of 53 patients with elbow conditions who underwent surgery between December 2020 and December 2023 was performed. All patients received an X-ray of the elbow and electromyography (ENMG). The following scores were recorded: NRS, MEPS, and McGowan, both preoperatively and at the 1-year follow-up.
The NRS score decreased from 7.9 ± 0.8 (range: 6-9) to 2.8 ± 1.3 (range: 0-7) at the 1-year follow-up. MEPS improved from 70.7 ± 15.9 (range: 20-100) to 96.5 ± 7.2 (range: 70-100), indicating reduced pain and improved elbow function. The McGowan scale showed improvements in 49 out of 53 cases. All patients, except one, were satisfied with the surgery, and no recurrence of ulnar nerve-related pain was observed.
Preliminary results suggest that covering the ulnar nerve with an adipofascial flap following neurolysis and/or anterior transposition is an effective method for managing ulnar nerve entrapment. It appears to help prevent post-surgical complications and adhesions, which are the main causes of the high recurrence rates reported in the literature.
尺神经卡压是一种常见病症，手术复发率高达25%。在这种情况下，治疗仍存在争议。在肘部手术中，即使没有明显症状，对尺神经的处理和进行神经松解通常也是初始步骤。在本研究中，我们评估了在肘部手术中使用脂肪筋膜瓣覆盖神经的临床适用性。
对2020年12月至2023年12月期间接受手术的53例肘部疾病患者进行回顾性研究。所有患者均接受了肘部X线检查和肌电图（ENMG）检查。记录术前及术后1年的以下评分：数字疼痛评分量表（NRS）、改良总有效率评分（MEPS）和麦高恩（McGowan）评分。
在1年随访时，NRS评分从7.9±0.8（范围：6 - 9）降至2.8±1.3（范围：0 - 7）。MEPS从70.7±15.9（范围：20 - 100）提高到96.5±7.2（范围：70 - 100），表明疼痛减轻且肘部功能改善。麦高恩量表显示53例中有49例有改善。除1例患者外，所有患者对手术满意，未观察到尺神经相关疼痛复发。
初步结果表明，在神经松解和/或前移术后用脂肪筋膜瓣覆盖尺神经是治疗尺神经卡压的有效方法。它似乎有助于预防术后并发症和粘连，而这些是文献中报道的高复发率的主要原因。
