肘管综合征尺神经的前置方式及其疗效比较

目的分析比较两种尺神经前置方式治疗肘管综合征的疗效。方法回顾分析45例肘管综合征病例，分别采用尺神经皮下前置和肌下前置两种不同手术方式；获得随访31例，其中行皮下前置23例，肌下前置8例。结果术后随访6个月-8年，平均2．4年。23例皮下前置者疗效优8例，良11例，可3例，差1例，优良率82．6％；8例肌下前置者疗效优2例，良4例，可1例，差1例，优良率75％。尺神经皮下前置和肌下前置的效果没有显著差异，但肘管综合征中度患者的疗效明显好于重度患者。结论肘管综合征的治疗最重要的是对肘管和尺神经彻底的减压，皮下前置和肌下前置两种手术方式的效果没有差异。肘管综合征一旦明确诊断，应积极行手术治疗。

Cubital tunnel syndrome: discussion of different anterior transpositions of ulnar nerve and comparison of respective effect

Objective To analyze and compare the effect of two different anterior transpositions of the ulnar nerve for cubital tunnel syndrome. Methods Forty-five cases have been reviewed from 1991 to 2003. The patients were treated with two different operative ways: anterior subcutaneous and submuscular transposition of ulnar nerve. Results Thirty-one cases were followed up from 6 months to 8 years with an average time of 2.4 years. In subcutaneous group, 8 cases were excellent, 11 good, 3 fair and 1 poor, with 82.6% rate of excellent or good. In submuscular group, 2 were excellent, 4 good, 1 fair and 1 poor, with 75% rate of excellent or good respectively. Statistical analysis stated of two anterior transpositions had no significant difference, but the effect of moderate-staged patients was obviously better than that of severe-staged patients. Conclusion Complete tunnel and nerve decompression was the most important step of the treatment of cubital tunnel syndrome. There is no difference between subcutaneous and submuscular transposition of ulnar nerve.Cubital tunnel syndrome should be operated actively since it was diagnosed.