改良筋膜瓣在尺神经松解皮下前置术中的应用

目的 探讨在尺神经松解前置术中应用改良筋膜瓣技术治疗中重度肘管综合征的疗效.方法 对2015年1月至2016年6月我院收治的34例中重度肘管综合征患者,术前应用McGowan(MGG)分级结合肌电(electromyography,EMG)检查,行尺神经松解并应用改良筋膜瓣皮下前置术,术后随访观察患者恢复情况.结果 34例经过6～14个月的随访,术后恢复情况采用中华手外科学会的肘管综合征功能评定标准评定,优16例,良13例,可5例;优良率为88.30％.所有患者无肘部不适感.结论 应用改良的筋膜瓣技术治疗中重度肘管综合征,术中对尺神经不会形成二次卡压,对原尺神经沟封闭效果良好,最大限度地难免了尺神经再度滑移至原尺神经沟.术后无需石膏固定,可早期恢复正常生活与工作.

Application of modified fascia flap in anterior transposition of the ulnar nerve

Objective To evaluate the efficacy of anterior subcutaneous transposition of the ulnar nerve by modified fascial flap in patients with moderate to severe cubital tunnel syndrome.Methods From January 2015 to June 2016,34 cases of moderate and severe cubital tunnel syndrome underwent the operation of the ulnar neurolysis and subcutaneous anterior transposition by modified fascial flap.And the recovery of patients after surgery was observed.Results After 6 to 14 months follow-up,postoperative recovery by tunnel syndrome function evaluation criteria of the Chinese Society of Hand Surgery:excellent in 16 cases,good in 13 cases,fair in 5 cases.The excellent and good rate was 88.30％.All patients had no elbow discomfort.Conclusion By the modified fascial flap technique in treatment of cubital tunnel syndrome,the ulnar nerve will not be formed again,and it has good effect on the sealing effect of the original ulnar nerve groove.It is unavoidable to slip the ulnar nerve to the original ulnar nerve groove farthest.No need for plaster fixation postoperatively.Patients can carry out early protective activities,as soon as possible to restore normal life and work.