The Effect Of Two Technique Type To Moderate And Severe Cubital Tunnel Syndrome With Review Research

Objective:To compare the clinical efficacy of ulnar nerve anterior subcutaneous transposition and ulnar nerve anterior intramuscular transposition in moderate and severe cubital tunnel syndrome and their advantages and disadvantages, in order to provide a basis to select the appropriate operation of clinical programs.Methods:(1) Based retrospective cohort study of clinical epidemiology of design patterns, recalling the collection in January 2000-200610 months in patients with moderate or severe cubital tunnel syndrome, where subcutaneous pre-surgery group of 40 patients, cases are from the Jin Dynasty Coal General Hospital, Medical Records departments provide, in chronological order to choose moderate to severe cubital tunnel syndrome, primary data selection criteria at the same time a full case, individual data missing persons by telephone or other means of communication to be completed, the final total of 40 cases were included in the analysis of cases; intramuscular transposition group of 40 patients with same collection method, according to the conditions of cases collected and subcutaneous pre-selected group of the same period patient age, gender, disease duration, similar to the basic cause of moderate and severe cubital tunnel syndrome patients, a total of 40 cases. (2) conducted balance tests of the general characteristics, profession, disease severity of two groups patients before surgery; according to 2000 Hand Surgery Society of Chinese Medical Association adopted by the ulnar nerve function assessment criteria to evaluate a trial in patients with ulnar nerve deficit situation and the severity. Rates, including patients with finger shape, ring the little finger flexor function and feeling of three, a total of 12 points, defects in the more light, the higher of the score, the excellent was 10～12 points, the good was in 7～9 hours, the normal was 4 to 6 points,the poor was below 3 points. Statistical method use t-test or Chi-square test. (3) Postoperative Evaluation:compared the situation improved and the flexibility of the little finger and ring finger of two groops in 10 days after surgery; compared ulnar nerve function impairment of two groups in 1 year after surgery; compared long-term outcome of two groups in 3 year after surgery. Statistical method use t-test or Chi-square test.Results:(1) the general characteristics of the two groups before surgery, duration, occupation, preoperative ring refers to the deep feelings and the little finger flexor muscle strength, balance flexibility finger test was not statistically significant, two groops were comparable; ulnar nerve function deficit score 2 group of comparison, the statistical test, there was no significant difference between the two groups in the number of severe cases of comparison, they were comparable. (2) two groups of patients after operation on the 10th ring finger little finger numbness to improve the situation. and more flexible than before operation were improved, which ring the little finger numbnessχ2= 0.350, P> 0.05, finger dexterityχ2= 0.069, P> 0.05; (3) one year after the ulnar, nerve function deficit had improved significantly compared with the preoperative (ulnar nerve anterior subcutaneous transposition group of patients pre-3.6±2.3 points, after 7.6±2.2 points, t= 2.095, P<0.05; ulnar nerve anterior intramuscular transposition group of patients pre-3.7±2.1 points before and after 8.7±2.4 points, t= 2.217, P<0.05), two groups of patients have more significant differences (t= 2.137, P <0.05). (4) two sets of long-term effect after three years, compared to subcutaneous transposition group was 75%excellent and good rate, intramuscular transposition group was excellent and good rate was 95%, statistically significant difference between the two groups (χ2= 6.275, P <0.05), the two groups after th e merger Total patients with moderate and severe fine rate and the total rate is relatively good in patients with statistically different (χ2= 8.375, P<0.05), to exclude confounding factors, respectively, by moderate and severe patients when compared with subcutaneous transposition group of excellent and good rate in patients with moderate 92%, intramuscular transposition group of patients with moderate fine rate was 100%, no significant difference between the two groups (P= 0.491> 0.05), subcutaneous transposition group of excellent and good rate in patients with moderate and severe 46.6%, intramuscular transposition group excellent in patients with severe pre-group the rate of 83.3%difference between the two groups was statistically significant (P= 0.020<0.05).Conclusions:To some extent,ulnar nerve anterior intramuscular transposition was superior to ulnar nerve anterior subcutaneous transposition because pre-operative intramuscular method was simple, easy to form the pressure of the ulnar nerve for front and accompanying blood vessels to provide a good vascular bed, a year after surgery the ulnar nerve had good effect, even after three years or long-term after ulnar nerve anterior intramuscular transposition the effects of ulnar nerve the skin restored in the severe patients was better than ulnar nerve anterior subcutaneous transposition.