Revision surgery for recurrent ulnar nerve compression following failed subcutaneous transposition : Author list.

IF 1.9 3区医学 Q3 CLINICAL NEUROLOGY

Acta Neurochirurgica Pub Date : 2024-09-09 DOI:10.1007/s00701-024-06255-z

Lingkang Zhu, Fangjing Yang, Xuanyu Zhao, Yundong Shen, Yanqun Qiu, Wendong Xu

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引用次数: 0

Abstract

Background: Recurrent ulnar nerve compression after primary anterior subcutaneous transposition is relatively rare, and revision surgery is challenging. This study retrospectively evaluated the clinical outcomes of revision anterior subcutaneous transposition for recurrent ulnar nerve compression.

Methods: Eight patients who underwent revision anterior subcutaneous transposition for recurrent ulnar nerve compression were enrolled in this study. The outcomes were based on preoperative and postoperative symptoms, physical examination findings, and electromyographic evaluation.

Results: Ulnar nerve enlargement was preoperatively found in all patients with a mean cross sectional area of 0.15 cm² (range, 0.14-0.18 cm²). Intraoperative findings showed that recurrent compression occurred in three areas, including the medial intermuscular septum (n = 5), the medial epicondyle (n = 6) and nerve entrance to forearm fascia (n = 1). Post-operation, significant improvements were observed in ring/little finger numbness (from severe to mild, p = 0.031), grip strength (from 48.00% to 80.38% of the intact side, p < 0.001) and McGowan grade (from Grade III to Grade I, p = 0.049). Postoperative electromyography test also showed significant improvement in motor nerve conduction at elbow (velocity, 23.30 ± 9.598 vs. 35.30 ± 9.367, p = 0.012; amplitude, 3.40 ± 3.703 vs. 5.65 ± 2.056, p = 0.007) and sensory nerve conduction at wrist (velocity, 27.04 ± 22.450 vs. 36.45 ± 18.099, p = 0.139; amplitude, 1.44 ± 1.600 vs. 4.00 ± 2.642, p = 0.011). Seven of the eight patients reported satisfaction with the postoperative results.

Conclusions: Revision anterior subcutaneous transposition was an effective treatment for recurrent ulnar nerve compression from prior failed procedures.

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皮下转位术失败后尺神经复发压迫的翻修手术：作者列表。

背景：原发性皮下前路转位术后尺神经复发压迫相对罕见，翻修手术具有挑战性。本研究回顾性评估了翻修性前皮下转位术治疗尺神经复发性压迫的临床效果：本研究共纳入了八名因尺神经返流受压而接受翻修性前皮下转位术的患者。研究结果基于术前和术后症状、体格检查结果和肌电图评估：结果：所有患者术前均发现尺神经扩张，平均横截面积为 0.15 平方厘米（0.14-0.18 平方厘米）。术中发现，复发性压迫发生在三个部位，包括内侧肌间隔（5 例）、内侧上髁（6 例）和前臂筋膜神经入口（1 例）。手术后，无名指/小指麻木（从严重到轻微，P = 0.031）、握力（从完好一侧的 48.00% 到 80.38%，P 结论：无名指/小指麻木明显改善：翻修性前皮下转位术是治疗之前失败手术造成的尺神经复发性压迫的有效方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Neurochirurgica 医学-临床神经学

CiteScore

4.40

自引率

4.20%

发文量

342

审稿时长

1 months

期刊介绍： The journal "Acta Neurochirurgica" publishes only original papers useful both to research and clinical work. Papers should deal with clinical neurosurgery - diagnosis and diagnostic techniques, operative surgery and results, postoperative treatment - or with research work in neuroscience if the underlying questions or the results are of neurosurgical interest. Reports on congresses are given in brief accounts. As official organ of the European Association of Neurosurgical Societies the journal publishes all announcements of the E.A.N.S. and reports on the activities of its member societies. Only contributions written in English will be accepted.