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Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition) ›› 2024, Vol. 10 ›› Issue (02): 111-116. doi: 10.3877/cma.j.issn.2096-0263.2024.02.007

• Hand Surgery • Previous Articles    

Comparative study of simple decompression versus anterior subcutaneous transposition in the treatment of moderate cubital tunnel syndrome

Wenli Chang1, Yafang Liu2, Xiaolei Su1, Guangxian Chen1, Xuelei Zhang1, Jianyong Zhao1,()   

  1. 1. Department of Hand Microsurgery, Cangzhou Hospital of Integrated TCM-WM Hebei, Cangzhou 061000, China
    2. Department of Ultrasound, Cangzhou Hospital of Integrated TCM-WM Hebei, Cangzhou 061000, China
  • Received:2023-03-11 Online:2024-04-05 Published:2024-06-18
  • Contact: Jianyong Zhao

Abstract:

Objective

The purpose of this study was to compare the clinical efficacy of simple decompression versus anterior subcutaneous transposition in the treatment of moderate cubital tunnel syndrome.

Methods

Patients with moderate cubital tunnel syndrome admitted to Cangzhou Hospital of Integrated TCM-WM of Hebei from July 2018 to July 2019 were divided into treatment group (simple decompression group) and control group (anterior subcutaneous transposition group). General information such as gender, age, and duration of symptoms. The Semmes-Weinstein Monofilament of the little finger and two-point discrimination of the little finger were used as the indicators to evaluate the sensory recovery of the patients, and grip strength, pinch strength of the thumb and index, and motor nerve conduction velocity were used as the indicators to evaluate the motor of the patients. The postoperative complications of the two groups were recorded (elbow joint pain, ulnar nerve supracrustal dislocation, and incision infection). Patients in both groups were followed up for at least 12 months, and cross-group and intra-group comparisons were performed (preoperative, 12-month follow up).

Results

A total of 50 patients were included in this study, including 25 patients in the treatment group and 25 patients in the control group. There were no statistically significant differences in gender (χ2=0.081, P=0.777), age (t=0.117, P=0.907), symptom duration (t=-1.364, P=0.179) and follow-up time (Z=-0.865, P=0.387) between the two groups, indicating comparability. Semmes-Weinstein Monofilament of the little finger (Z=-0.990, P=0.322), two-point discrimination of the little finger (Z=-0.447, P=0.655) grip strength (t=0.711, P=0.481), pinch strength of the thumb and index (Z=-0.233, P=0.816), and motor nerve conduction velocity (Z=-1.438, P=0.150) in treatment group were significantly improved compared with those before treatment. Semmes-Weinstein Monofilament of the little finger (Z=-4.430, P=0.000), two-point discrimination of the little finger (Z=-4.526, P=0.000), grip strength (t=-33.597, P=0.000), pinch strength of the thumb and index (Z=-4.353, P=0.000), and motor nerve conduction velocity (Z=-4.449, P=0.000) in control group were significantly improved compared with those before treatment postoperative complications such as elbow pain, ulnar nerve subluxation, and incision infection were not found in both groups.

Conclusions

Simple decompression and Anterior subcutaneous transposition of the ulnar nerve are safe and effective procedures, both of which can significantly improve motor and sensation in patients with moderate cubital tunnel syndrome. Anterior subcutaneous transposition of the ulnar nerve resulted in more intraoperative blood loss and postoperative drainage.

Key words: Cubital tunnel syndrome, Decompression, Grip strength, Pinch strength

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