肘外翻畸形导致肘管综合征的相关因素分析

RELATED FACTOR ANALYSIS OF CUBITAL TUNNEL SYNDROME CAUSED BY CUBITUS VALGUS DEFORMITY

目的回顾性分析肘外翻畸形导致肘管综合征的相关因素,为肘管综合征临床治疗提供理论依据。方法 2002年6月-2008年9月,对40例肘外翻畸形导致肘管综合征患者采用肘管尺神经松解前移术治疗,手术前后分别采用Yokohama City University肘管综合征评分标准对尺神经功能进行评分。采用logistic回归分析影响尺神经损害和预后的相关因素。结果 40例患者获随访12～75个月,平均27.5个月。影响尺神经损害严重程度的相关因素有:肘外翻畸形持续时间(OR=1.005,P=0.045)、肘外翻角度(OR=9.374,P=0.000)和肌肉萎缩持续时间(OR=4.358,P=0.010)。影响尺神经炎预后的相关因素有:肌肉萎缩持续时间(OR=8.489,P=0.000)、肘外翻角度(OR=2.802,P=0.030)和手术时患者年龄(OR=4.611,P=0.031)。结论影响尺神经损害严重程度的相关因素有肘外翻畸形持续时间、肘外翻角度和肌肉萎缩持续时间。影响尺神经炎预后的相关因素有手术时患者年龄、肘外翻角度和肌肉萎缩持续时间。对肘外翻畸形导致的肘管综合征患者应早诊断,并及早行肘管尺神经松解前移手术治疗。

Objective To explore related factors of cubital tunnel syndrome caused by cubitus valgus deformity so as to provide theoretical basis for the clinical treatment. Methods Between June 2002 and September 2008, 40 patients with cubital tunnel syndrome caused by cubitus valgus deformity underwent anterior subcutaneous ulnar transposition. Related factors was analysed through logistic regression analysis using scoring standard recommended by Yokohama City University. Results All 40 patients were followed up 27.5 months on average （range, 12-75 months）. The duration of cubitus valgus deformity, cubitus valgus deformity angle, and the duration of paraesthesia and muscular atrophy were identified as related factors for ulnar neuropathy and the odds ratios were 1.005 （P=0.045）, 9.374 （P=0.000）, and 4.358 （P=0.010）, respectively. The related prognosis factors were duration of paraesthesia and muscular atrophy, deformity angle, and age at surgery, with odds ratios of 8.489 （P=0.000）, 2.802 （P=0.030）, and 4.611 （P=0.031）, respectively. Conclusion Related factors for ulnar neuropathy are durations of cubitus valgus deformity, cubitus valgus deformity angle, and duration of paraesthesia and muscular atrophy. Related factors for prognosis include age at surgery, cubitus valgus deformity angle, and duration of muscular atrophy. Early anterior subcutaneous ulnar transposition should be performed in patients with cubital tunnel syndrome caused by cubitus valgus deformity