[논문]Simple Decompression of the Ulnar Nerve for Cubital Tunnel Syndrome

Cho, Yong-Jun; Cho, Sung-Min; Sheen, Seung-Hoon; Choi, Jong-Hun; Huh, Dong-Hwa; Song, Joon-Ho

doi:10.3340/jkns.2007.42.5.382

Simple Decompression of the Ulnar Nerve for Cubital Tunnel Syndrome 원문보기

Journal of Korean Neurosurgical Society = 대한신경외과학회지, v.42 no.5, 2007년, pp.382 - 387

Cho, Yong-Jun (Department of Neurosurgery Chunchon Sacred Heart Hospital College of Medicine Hallym University) , Cho, Sung-Min (Department of Neurosurgery Chunchon Sacred Heart Hospital College of Medicine Hallym University) , Sheen, Seung-Hoon (Department of Neurosurgery Chunchon Sacred Heart Hospital College of Medicine Hallym University) , Choi, Jong-Hun (Department of Neurosurgery Chunchon Sacred Heart Hospital College of Medicine Hallym University) , Huh, Dong-Hwa (Department of Neurosurgery Chunchon Sacred Heart Hospital College of Medicine Hallym University) , Song, Joon-Ho (Department of Neurosurgery Chunchon Sacred Heart Hospital College of Medicine Hallym University)

Abstract ▼ AI-Helper

Objective : Cubital tunnel syndrome is the second most common entrapment neuropathy of the upper extremity. Although many different operative techniques have been introduced, none of them have been proven superior to others. Simple cubital tunnel decompression has numerous advantages, including simplicity and safety. We present our experience of treating cubital tunnel syndrome with simple decompression in 15 patients. Methods : According to Dellon's criteria, one patient was classified as grade 1, eight as grade 2, and six as grade 3. Preoperative electrodiagnostic studies were performed in all patients and 7 of them were rechecked postoperatively. Five patients of 15 underwent simple decompression using a small skin incision (2 cm or less). Results : Preoperative mean value of motor conduction velocity (MCV) within the segment (above the elbow-below the elbow) was $41.8{\pm}15.2\;m/s$ and this result showed a decrease compared to the result of MCV in the below the elbow-wrist segment ($57.8{\pm}6.9\;m/s$) with statistical significance (p<0.05). Postoperative mean values of MCV were improved in 6 of 7 patients from $39.8{\pm}12.1\;m/s$ to $47.8{\pm}12.1\;m/s$ (p<0.05). After an average follow-up of $4.8{\pm}5.3$ months, 14 patients of 15 (93%) reported good or excellent clinical outcomes according to a modified Bishop scoring system. Five patients who had been treated using a small skin incision achieved good or excellent outcomes. There were no complications, recurrences, or subluxation of the ulnar nerve. Conclusion : Simple decompression of the ulnar nerve is an effective and successful minimally invasive technique for patients with cubital tunnel syndrome.

주제어

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가설 설정

A 2 cm skin incision made between the medial epicondyle (E) and olecranon (0). B : Intraoperative photograph demonstrating the ulnar nerve and overlying fascial membranes within the c 니 bital t 니 nnel.

제안 방법

3 (range, 1-18) months. Despite conservative treatment, all patients had continuous numbness or tingling in the ring and little fingers with or without motor deficits, and/or persistent pain along the ulnar border of the hand and forearm, at times extending into the shoulder Each patient was examined preoperatively and the following data were evaluated; initial chief complaint, duration of symptoms, Tinels sign around the elbow, provocation test by the elbow flexion test, and the results of the electrodiagnostic studies.
0, Chicago, Illinois). The Wilcoxon signed ranks test was used to assess any significant difference between preoperative and postoperative data. A ^-value of 0.

대상 데이터

An inching technique between 4 cm distal and 6 cm proximal to the medial epicondyle was also simultaneously applied to all of the patients to determine the exact location of the compression site. Postoperative MCV of the ulnar nerve in the affected limb was examined 1 and 3 months using the same tests in 7 of 15 patients. The obtained data were compared with the preoperative results.

성능/효과

According to a modified Bishop scoring system, 11 patients (73.3%) were clinically graded as excellent (five scored 12, three scored 11, two scored 10, and one scored 9), 3 (20%) were graded as good (scores of 7), and 1 (6.7%) was graded. as feir (Table 3).
In 6 of these patents (86%), the mean value of MCV had improved with statistical significance from 39.8 士 12.1 m/s to 47, 8 ±12.1 m/s (/><0.05). The one patient who had not shown improvement in the postoperative result of MCV had the longest duration of the symptom before surgery (24 months) among all patients.
Postoperative clinical outcome was assessed in all patients according to a modified Bishop scoring system, excellent score as above 8 points out of the 12 points scoring system, good between 5 to 7, fair between both 3 and 4, and poor as below 219, 27) (Table 2).

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Simple Decompression of the Ulnar Nerve for Cubital Tunnel Syndrome 원문보기

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Simple Decompression of the Ulnar Nerve for Cubital Tunnel Syndrome 원문보기

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