小切口治疗肘管综合征的临床疗效分析

Clinical outcomes analyis of small incision cubital tunnel release

目的探讨小切口治疗肘管综合征的临床应用。方法2010年12月至2011年11月，对12例肘管综合征患者术前肌电图评估尺神经损伤的程度，采用小切口加肱骨内上髁部分切除的方法进行治疗。术后石膏托固定2d，保护性地活动肘关节。结果12例患者均获得随访，时间为4个月至1年，感觉较术前有明显改善，神经支配的手外在肌肌力较术前增强，手内在肌均没有进一步的萎缩，6例爪形手程度有所改善。按中华医学会手外科学会上肢部分功能评定试用标准评定：优6例，良4例，可2例；优良率83．3％。结论在把握好适应证的情况下，采用小切口加肱骨内上髁部分切除治疗肘管综合征是一种可行的方法。

Objective To discuss the clinical application of small incision release for treatment of cubital tunnel syndrome. Methods Twelve cases of cubital tunnel syndrome treated from December 2010 to November 2011 were involved. The preoperative function of the ulnar nerve was evaluated by electromyography. Partial resection of the medial epicondyle and decompression of the ulnar nerve was carried out through a small incision. Postoperative immobilization with a plaster cast lasted for 2 days to protect elbow from excessive movement. Results All of 12 cases were follow-up for 4 months to one year. Markedly improved sensation and extrinsic muscle strength were noted. There was no further atrophy of the intrinsic hand muscles. Claw hand deformities of 6 eases were corrected to some extent. According to the criteria for functional assessment of the upper extremity issued by the Chinese Hand Surgery Society, the results were graded as excellent in 6 cases, good in 4 cases, and fair in 2 cases. The overall rate of excellent and good was 83.3 %. Conclusion When properly indicated, cubital tunnel syndrome can be treated with small-incision partial resection of the medial eoicondvle.