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Setting expectations following endoscopic cubital tunnel release

机译:内镜下肘管释放后设定期望

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Background The objective was to evaluate recovery characteristics of patients undergoing endoscopic cubital tunnel release (ECuTR) by determining the following: (1) return to work (RTW) times following ECuTR compared with RTW times of patients that underwent anterior transposition of the ulnar nerve (ATUN), (2) satisfaction rates and factors affecting satisfaction, (3) resolution rates of common preoperative complaints and findings, and (4) effect of preoperative ulnar nerve subluxation on postoperative outcomes. Methods A total of 172 cases in 148 patients undergoing ECuTR were prospectively enrolled including 56 women and 92 men. Kaplan-Meier analyses were performed to determine RTW time for ECuTR patients and for a cohort of 15 patients that underwent ATUN. Patients were evaluated for subjective and objective complaints preoperatively and postoperatively. Cases were grouped by Dellon’s classification preoperatively and modified by Bishop’s postoperatively. Results Half of ECuTR patients returned to normal work within 8?days postoperatively versus 71?days following ATUN. Variables significantly negatively affecting RTW were male sex, manual labor, and worker’s compensation status. Dellon’s was the best predictor of postoperative satisfaction. Complete resolution of symptoms occurred in 86?% of patients for weakness, 81?% for pain, 79?% for numbness and tingling (N/T), 78?% for atrophy, 76?% for abnormal two-point discrimination, and 65?% for Wartenberg’s. Preoperative ulnar nerve subluxation had no effect on outcome. Conclusions Improved RTW time following ECuTR versus ATUN indicates potential and substantial cost-saving implications with respect to reduced worker productivity loss. Patients with more severe preoperative Dellon’s classification can expect less optimal results regarding postoperative satisfaction and resolution rates of N/T and pain.
机译:背景技术目的是通过确定以下内容来评估接受内窥镜下肘管释放(ECuTR)的患者的恢复特征:(1)与接受尺神经前移的患者的RTW时间相比,ECuTR后的重返工作时间(RTW)( (ATUN),(2)满意率和影响满意度的因素,(3)术前常见主诉和发现的解决率,以及(4)术前尺神经半脱位对术后预后的影响。方法回顾性分析148例接受ECuTR的患者中的172例,其中女性56例,男性92例。进行Kaplan-Meier分析以确定ECuTR患者和15例接受ATUN的患者的RTW时间。在术前和术后对患者进行主观和客观主诉评估。术前根据Dellon的分类对病例进行分组,Bishop的术后对病例进行修改。结果一半的ECuTR患者在术后8天内恢复正常工作,而在ATUN术后71天内恢复了正常工作。显着负面影响RTW的变量是男性,体力劳动和工人的补偿状况。 Dellon是术后满意度的最佳预测指标。症状完全缓解的患者中,有86 %%的患者出现虚弱,81 %%的疼痛,79 %%的麻木和刺痛(N / T),78 %%的萎缩,76 %%的异常两点歧视,以及瓦滕伯格氏症占65%。术前尺神经半脱位对预后无影响。结论ECuTR与ATUN相比,RTW时间的缩短表明,在减少工人生产率损失方面,潜在的和实质性的成本节约意义。术前Dellon分类更为严重的患者,就术后满意度以及N / T和疼痛的解决率而言,预期的最佳效果可能会较差。

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