摘要目的 对比研究尺神经单纯减压、改良尺神经肌内前置和皮下前置三种手术方法治疗肘管综合征的临床疗效.方法 对2005年11月至2012年1月期间,在我院治疗的67例肘管综合征患者,其中采用尺神经单纯减压术26例,改良尺神经肌内前置术20例,尺神经皮下前置术21例.术后均获得10 ～ 58个月的随访,通过DASH评分,测量患侧握力、拇示指捏力、示中指捏力、患侧环小指S-W单丝、环小指两点分辨觉及运动两点分辨觉的比较,评价三种手术方法的治疗效果.结果 术后各组患者的临床症状均有明显改善,对三组随访结果中的症状项目和功能测定以及DASH评分进行统计学分析,三种术式比较疗效差异均无统计学意义.结论 尺神经单纯减压、改良尺神经肌内前置、皮下前置三种术式治疗肘管综合征在临床疗效上没有差别.

abstractsObjective To compare the clinical efficacy of simple decompression,modified intramuscular transposition and anterior subcutaneous transposition of the ulnar nerve in the treatment of cubital tunnel syndrome.Methods From November 2005 to January 2012,67 patients with cubital tunnel syndrome were treated.Among them,26 cases underwent simple decompression of the ulnar nerve,20 cases were treated by modified inwamuscular ulnar nerve transposition,and 21 cases were treated by anterior subcutaneous transposition of the ulnar nerve.Postoperative follow-up time ranged from 10 to 58 months.DASH score,grip strength,thumb-index finger pinch force,index-middle finger pinch force,Sernmes-Weinstein monofilament test of the ring and little fingem and moving and static two-point discrimination of the ring and little fingers were measured to evaluate the efficacy of the three types of surgery.Results Clinical improvement was observed in all the patients postoperatively.No statistically significant differences of the outcome measures were found among the three operative methods.Conclusion Simple decompression,modified intramusular transposition and anterior subcutaneous transposition of the ulnar nerve lead to similar results in the treatment of cubital tunnel syndrome.