中医疗法结合3D打印技术治疗中重度肘管综合征

目的:观察应用3D打印技术指导下的尺神经沟扩大成形术结合尺神经原位松解,术后给予针刺促进神经康复来治疗中重度肘管综合征的临床疗效.方法:自2016年4月—2019年3月,对40例由于肘关节退行性病变引起的尺神经沟骨赘生成造成尺神经卡压的中重度肘管综合征患者,根据其术前肘关节CT平扫三维重建应用3 D打印技术打印肘关节模...

Treatment of Moderate-severe Cubital Tunnel Syndrome with Integrated Traditional Chinese and Western Medicine Therapy Combined with 3D Printing Technology

Objective To observe the clinical effect of ulnar nerve groove plasty under the guidance of 3D printing technology combined with in situ release of ulnar nerve, and postoperative acupuncture to promote nerve rehabilitation in the treatment of moderate to severe cubital tunnel syndrome. Methods From April 2016 to March 2019, 40 patients with moderate to severe cubital tunnel syndrome caused by ulnar nerve entrapment due to osteophyte formation of ulnar nerve groove caused by elbow degenerative disease were selected. According to the preoperative three-dimensional reconstruction of elbow joint by plain CT scan, the elbow joint model was printed by 3D printing technology. According to the concept of "cubital canal index" proposed by orthopedics personnel in our hospital, the ulnar nerve groove was calculated by computer. After releasing the ulnar nerve in situ, according to the size of the "test model", the ulnar nerve groove was expanded and deepened by speed burr. After releasing the ulnar nerve, the ulnar nerve was put into the expanded cubital canal again and the Osborne ligament suture was reconstructed. At the same time, acupuncture was used for treatment. The main acupoints were the acupoints along the hand Taiyang small intestine meridian of ulnar nerve. Ten days was a course of treatment, and three courses of acupuncture were used. After each course of treatment, the rest was three days. Results The wounds of 40 patients were healed in the first stage, and no hematoma was found. One patient gave up acupuncture treatment because of fear of acupuncture. All patients were followed up for 12-18 months (average 13.6 months). The motor sensory conduction velocity, two-point discrimination, grip strength and lateral pinch strength (percentage of contralateral) were significantly improved 12 months after operation compared with those before operation (P<0.05). According to the evaluation standard of upper limb function of hand surgery branch of Chinese Medical Association, 28 cases were excellent, 10 cases were good, 1 case was fair and 1 case was poor. The excellent and good rate was 95%. Conclusion Under the guidance of 3D printing technology, cubital tunnel plasty and ulnar nerve in situ release, combined with traditional Chinese medicine acupuncture treatment of moderate to severe cubital tunnel syndrome has a certain clinical effect.