OBJECTIVE:To explore the optimal surgery in treating moderate-severe cubital tunnel(CuTS) syndrome by comparing the clinical efficiency of decompression and anterior subcutaneous transposition of ulnar nerve and decom...OBJECTIVE:To explore the optimal surgery in treating moderate-severe cubital tunnel(CuTS) syndrome by comparing the clinical efficiency of decompression and anterior subcutaneous transposition of ulnar nerve and decompression and anterior submuscular transposition of ulnar nerve,and to provide a theoretical basis for the appropriate surgical programs in treating moderate-severe Cu TS.METHODS:47 consecutive cases of moderate-severe Cu TS were surgically treated in our department from January 2014 to January 2017.All patients were divided into two groups by the doctor in our department.21 Cu TS cases were treated with decompression and anterior subcutaneous transposition of ulnar nerve,and other 26 cases were treated with decompression and anterior submuscular transposition of ulnar nerve.All the patients were followed 1 month,3 months and 6 months after operation to evaluate the recovery degree of ulnar nerve function and the clinical efficiency of the two methods was compared.RESULTS:Clinical symptoms of two groups were significant alleviated.There was no significant statistical difference between two groups in the clinical efficiency.CONCLUSION:Completely releasing of nerve truck is the most important step in treating mediate-severe Cu TS.Theclinical results of the two methods are similar,but the anterior subcutaneous transposition of ulnar nerve is more easy to operate and can be widely used.展开更多
Although several surgical procedures exist for treating cubital tunnel syndrome, the best surgical option remains controversial. To evaluate the efficacy of anterior subcutaneous transposition of the ulnar nerve in pa...Although several surgical procedures exist for treating cubital tunnel syndrome, the best surgical option remains controversial. To evaluate the efficacy of anterior subcutaneous transposition of the ulnar nerve in patients with moderate to severe cubital tunnel syndrome and to analyze prognostic factors, we retrospectively reviewed 62 patients（65 elbows） diagnosed with cubital tunnel syndrome who underwent anterior subcutaneous transposition. Preoperatively, the initial severity of the disease was evaluated using the Mc Gowan scale as modified by Goldberg： 18 patients（28%） had grade IIA neuropathy, 20（31%） had grade IIB, and 27（42%） had grade III. Postoperatively, according to the Wilson ＆ Krout criteria, treatment outcomes were excellent in 38 patients（58%）, good in 16（25%）, fair in 7（11%）, and poor in 4（6%）, with an excellent and good rate of 83%. A negative correlation was found between the preoperative Mc Gowan grade and the postoperative Wilson ＆ Krout score. The patients having fair and poor treatment outcomes had more advanced age, lower nerve conduction velocity, and lower action potential amplitude compared with those having excellent and good treatment outcomes. These results suggest that anterior subcutaneous transposition of the ulnar nerve is effective and safe for the treatment of moderate to severe cubital tunnel syndrome, and initial severity, advancing age, and electrophysiological parameters can affect treatment outcome.展开更多
文摘OBJECTIVE:To explore the optimal surgery in treating moderate-severe cubital tunnel(CuTS) syndrome by comparing the clinical efficiency of decompression and anterior subcutaneous transposition of ulnar nerve and decompression and anterior submuscular transposition of ulnar nerve,and to provide a theoretical basis for the appropriate surgical programs in treating moderate-severe Cu TS.METHODS:47 consecutive cases of moderate-severe Cu TS were surgically treated in our department from January 2014 to January 2017.All patients were divided into two groups by the doctor in our department.21 Cu TS cases were treated with decompression and anterior subcutaneous transposition of ulnar nerve,and other 26 cases were treated with decompression and anterior submuscular transposition of ulnar nerve.All the patients were followed 1 month,3 months and 6 months after operation to evaluate the recovery degree of ulnar nerve function and the clinical efficiency of the two methods was compared.RESULTS:Clinical symptoms of two groups were significant alleviated.There was no significant statistical difference between two groups in the clinical efficiency.CONCLUSION:Completely releasing of nerve truck is the most important step in treating mediate-severe Cu TS.Theclinical results of the two methods are similar,but the anterior subcutaneous transposition of ulnar nerve is more easy to operate and can be widely used.
基金supported by grants from the National Program on Key Basic Research Project of China(973 Program),No.2014CB542200a grant from Innovation Program of Ministry of Education,No.IRT1201+1 种基金the National Natural Science Foundation of China,No.31271284,31171150,81171146,30971526,31100860,31040043,31371210Program for New Century Excellent Talents in University of Ministry of Education of China,No.BMU20110270
文摘Although several surgical procedures exist for treating cubital tunnel syndrome, the best surgical option remains controversial. To evaluate the efficacy of anterior subcutaneous transposition of the ulnar nerve in patients with moderate to severe cubital tunnel syndrome and to analyze prognostic factors, we retrospectively reviewed 62 patients（65 elbows） diagnosed with cubital tunnel syndrome who underwent anterior subcutaneous transposition. Preoperatively, the initial severity of the disease was evaluated using the Mc Gowan scale as modified by Goldberg： 18 patients（28%） had grade IIA neuropathy, 20（31%） had grade IIB, and 27（42%） had grade III. Postoperatively, according to the Wilson ＆ Krout criteria, treatment outcomes were excellent in 38 patients（58%）, good in 16（25%）, fair in 7（11%）, and poor in 4（6%）, with an excellent and good rate of 83%. A negative correlation was found between the preoperative Mc Gowan grade and the postoperative Wilson ＆ Krout score. The patients having fair and poor treatment outcomes had more advanced age, lower nerve conduction velocity, and lower action potential amplitude compared with those having excellent and good treatment outcomes. These results suggest that anterior subcutaneous transposition of the ulnar nerve is effective and safe for the treatment of moderate to severe cubital tunnel syndrome, and initial severity, advancing age, and electrophysiological parameters can affect treatment outcome.
