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Anterior Subcutaneous Transposition of the Ulnar Nerve Affects Elbow Range of Motion: A Mean 1.3.5 Years of Follow-up

摘要Background:Surgical decompression of the ulnar nerve is effective for cubital tunnel syndrome.However,deep approaches may result in iatrogenic elbow stiffness.This long-term study was to evaluate the range of motion (ROM) of the elbow and functional outcomes after anterior subcutaneous transposition.Methods:A total of 115 patients (78 male and 37 female;mean age:46.6 years) who underwent anterior subcutaneous transposition of the ulnar nerve between 2001 and 2005 were evaluated retrospectively;mean follow-up was 13.5 years.Elbow ROM was measured as flexion arc,flexion,and extension preoperatively and at the final follow-up,and compared via a mixed analysis of variance adjusting for age.Neuropathy was assessed preoperatively using a modified McGowan neuropathy grade and postoperatively using modified Wilson-Krout criteria.An ordinal logistic regression analysis used postoperative modified Wilson-Krout criteria as the outcome and preoperative factors as predictors.Results:Preoperative McGowan grades were Grade 1 in 14 patients (12.2%),Grade 2A in 28 (24.3%),Grade 2B in 53 (46.1%),and Grade 3 in 20 (17.4%) patients.Postoperatively,66 patients (57.4%) had excellent results,26 (22.6%) had good results,16 (13.9%) had fair results,and 7 (6.1%) had poor results at the final follow-up,as per the Wilson-Krout criteria.There were no complications.Pre-and postoperative elbow ROM was significantly decreased in patients with previous trauma or surgery of the elbow compared with those without (P < 0.05).Anterior subcutaneous transposition of the ulnar nerve did not significantly affect elbow ROM regardless of previous trauma or surgical history nor preoperative ROM (P > 0.05),after adjusting for age.Patients with prolonged symptoms prior to surgery and worse neuropathy tended to have less satisfactory functional outcomes (P < 0.05),after adjusting for covariates.Conclusions:Anterior subcutaneous transposition of the ulnar nerve is an effective and reliable treatment of cubital tunnel syndrome with satisfactory outcomes and minimal effect on elbow ROM.

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作者单位 Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing 100035, China [1] Department of Hand Surgery, Beijing Jishuitan Hospital, Beijing 100035, China [2]
栏目名称 Original Articles
DOI 10.4103/0366-6999.223851
发布时间 2018-03-21
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中华医学杂志(英文版)

中华医学杂志(英文版)

2018年131卷3期

282-288页

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