Balogh B, Vass A, Piza-Katzer H
Abteilung für Plastische und Wiederherstellungschirurgie und dem Ludwig-Boltzmann-Institut für Qualitätssicherung, Wien.
Handchir Mikrochir Plast Chir. 1997 May;29(3):133-8.
Anterior transposition of the ulnar nerve in cubital tunnel syndrome requires ligation of the segmental epineural vessels over 8 to 10 cm in order to free up and mobilize the nerve along its new course. As a result, the blood supply of ulnar nerves already compromised by entrapment is likely to be harmed even more. For the past three years we chose to perform simple decompression of the nerve with or without external/internal neurolysis on 33 patients (34 arms). After a follow-up time of six months to three years (mean 12 months), the outcome was evaluated by complete examination of hand function and by electrophysiologic studies. Four patients were excluded from the analysis due to short follow-up times. Four underwent decompression for mild entrapment symptoms, six for moderate symptoms, and 19 for severe symptoms. The functional outcome was rated as excellent in 26.7% (eight patients) and as good in 33.3% (ten patients). In group 3 (severe entrapment symptoms), seven patients (23.3%) showed moderate results and in four patients (13.3%) the outcome was poor. Considering that most of our patients had severe entrapment with advanced muscle atrophy, the overall outcome of decompression was satisfactory.
在肘管综合征中，尺神经前置术需要结扎8至10厘米长的节段性神经外膜血管，以便沿其新路径游离并移动神经。因此，已经因卡压而受损的尺神经血供可能会受到更大损害。在过去三年中，我们选择对33例患者（34条手臂）进行单纯神经减压术，同时或不进行外部/内部神经松解术。经过6个月至3年（平均12个月）的随访，通过对手部功能的全面检查和电生理研究来评估结果。4例患者因随访时间短而被排除在分析之外。4例因轻度卡压症状接受减压，6例因中度症状接受减压，19例因重度症状接受减压。功能结果评为优秀的占26.7%（8例患者），评为良好的占33.3%（10例患者）。在第3组（重度卡压症状）中，7例患者（23.3%）结果中等，4例患者（13.3%）结果较差。考虑到我们的大多数患者存在重度卡压并伴有晚期肌肉萎缩，减压的总体结果令人满意。
