尺神经原位松解术与尺神经松解皮下前置术治疗肘管综合征的疗效比较

摘要

目的 通过对尺神经原位松解术与尺神经松解皮下前置术治疗肘管综合征疗效的对照研究,探讨治疗肘管综合征的最佳手术方法.方法 经临床检查及肌电图证实的中重度肘管综合征患者68例,通过随机分组,33例行尺神经原位松解术(A组),35例行尺神经松解皮下前置术(B组).术后3个月、9个月随访,记录尺神经卡压恢复情况,包括手的握力、感觉、肘部尺神经传导速度,进行前瞻性对照研究.结果 对尺神经原位松解术与尺神经松解皮下前置术后尺神经恢复参数进行对照分析,行独立样本t检验,随访结果差异无统计学意义.结论 尺神经原位松解术与尺神经松解皮下前置术治疗肘管综合征疗效差异无统计学意义,建议采用创伤更小的尺神经原位松解术治疗无明显肘外翻畸形的肘管综合征.%Objective To evaluate which operative technique for treatment of cubital tunnel syndrome is preferable: subcutaneous anterior transposition or nerve decompression without transposition. Methods This study included 68 patients with clinically and electromyographically proven cubital tunnel syndrome. Thirty-three patients underwent ulnar nerve decompression without transposition and 35 underwent subcutaneous transposition of the ulnar nerve. Follow-up examinations evaluating hand grip and sensory as well as nerve conduction velocity around the elbow joint, were performed 3 and 9 months postoperatively. Results Statistical analysis, using the procedure of Independent -samples test, were conducted on the data. There was no significant difference between the outcomes of the two groups at either postoperative follow-up examination. Conclusion There is no significant difference between the outcomes of the subcutaneous anterior transposition and nerve decompression without transposition to treat cubital tunnel syndrome. We recommend simple decompression of the nerve in cases without deformity of the elbow, as this is the less invasive operative procedure.