Clinical Study Of Cubital Tunnel Expansion For The Treatment Of Cubital Tunnel Syndrome

Objective:Through the comparison and analysis of clinical curative effect between traditional anterior transposition and cubital tunnel expansion for the treatment of cubital tunnel syndrome caused by elbow articular degeneration and osteoarthritis,to evaluate the validity and reasonability of cubital tunnel expansion(CTE)releasing the ulnar nerve entrapment caused by the bony stenosis,which purpose to provide a new kind of reasonable operation choice for the treatment of degenerative cubital tunnel syndrome in the clinical.Methods: 40 patients diagnosed by CuTS who were hospitalized from June 2017 to July 2018 were selected,and their conditions were divided into two groups of moderate and severe with 20 patients in each group according to the Gu Yu Dong's classification of CuTS.SPSS software was used to randomly assign the two groups of patients to the cubital tunnel expansion group and the nerve preposition group for surgical treatment respectively.Patients in cubital tunnel expansion group were accepted the therapy of ulnar nerve relation and cubital tunnel expansion,while patients in nerve preposition group were accepted the therapy of ulnar nerve relation and preposition.After surgery,all the patients in two groups were accepted acupuncture and massage treatment by the doctor of traditional Chinese medicine.Recorded clinical data before surgery,and followed up all the patients in clinic at the first month,the third month and the sixth month respectively after surgery.The postoperative efficacy of the two groups was evaluated according to the Gu Yu Dong's functional evaluation criteria of CuTS,and the recovery degree of upper limb dysfunction and the improvement degree of life quality of the two groups were observed according to the DASH score.Results: All patients were followed up at the first month,the third month and the sixth month respectively after surgery,and the patients' conditions were improved in different degree.There was no significant difference in postoperative functional score at the first?the third and the sixth month respectively between the two groups of the moderate group(P>0.05).There was no significant difference in postoperative functional score at the first and the third month respectively between the two groups of the severe group(P>0.05).And there was a statistically significant difference in postoperative functional score at the sixth month between the two groups of the severe group(P=0.049).The differences of postoperative functional score at the sixth month of the two groups between the moderate group and the severe group were statistically significant(P<0.05).There was a statistically significant difference in postoperative DASH score at the sixth month between the two groups of the severe group(P=0.025).Conclusions:1.Cubital tunnel expansion can completely release the nerve by expanding the bone channel of the cubital tunnel.After preliminary observation,the effect is satisfying for the treatment of moderate and severe cubital tunnel syndrome with osteoarticular degeneration of the elbow joint,but the long-term effect still needs further follow-up and observation.2.Compared with traditional preposition surgery,the cubital tunnel expansion does not change the physiological position of the ulnar nerve,and maintains the integrity of the cubital tunnel by reconstruction of the arcuate ligament,which reduces the risk of postoperative re-injury and dislocation of the ulnar nerve.At the same time,the CTE conserved the blood supply of ulnar nerve around elbow joint,which could be beneficial to the recovery of the ulnar nerve.