McKee M D, Jupiter J B, Bosse G, Goodman L
University of Toronto, Canada.
J Bone Joint Surg Br. 1998 Jan;80(1):100-5. doi: 10.1302/0301-620x.80b1.7822.
We performed ulnar nerve neurolysis and transposition during reconstructive operations on 20 consecutive patients (21 elbows) with neuropathy after the failure of primary treatment of elbow fractures. There were 11 men and nine women with a mean age of 48.3 years. Preoperatively, four elbows were in McGowan stage I, seven in stage II and ten in stage III and the mean Gabel and Amadio ulnar nerve score was 3.2. At a mean follow-up of 32.1 months (24 to 67) we performed comprehensive neurological, functional, electrophysiological and outcome assessments. Patient satisfaction was high with good pain relief and restoration of hand strength and dexterity. The mean Gabel and Amadio score had improved to 6.5, an improvement of 3.3. There were one excellent, 16 good, 2 fair and 2 poor results; both of the last were due to failure of the underlying elbow reconstruction. Even for advanced stage-II and stage-III lesions we achieved good function, return of intrinsic power, and a high rate of patient satisfaction.
我们对20例（21个肘关节）初次治疗肘部骨折失败后出现神经病变的患者进行了重建手术，术中进行了尺神经松解和移位。其中男性11例，女性9例，平均年龄48.3岁。术前，4个肘关节处于麦高恩I期，7个处于II期，10个处于III期，加贝尔和阿马迪奥尺神经评分平均为3.2分。平均随访32.1个月（24至67个月），我们进行了全面的神经学、功能、电生理和疗效评估。患者满意度较高，疼痛得到有效缓解，手部力量和灵活性得以恢复。加贝尔和阿马迪奥评分平均提高到6.5分，提高了3.3分。结果为优1例，良16例，可2例，差2例；最后2例均因基础肘部重建失败所致。即使对于晚期II期和III期病变，我们也实现了良好的功能、内在力量的恢复以及较高的患者满意度。
