Short-term outcomes of percutaneous versus subcutaneous fascial flap fixation in cubital tunnel syndrome surgery: A retrospective cohort study.

IF 2.8 3区医学 Q1 ORTHOPEDICS

Journal of Orthopaedic Surgery and Research Pub Date : 2025-08-22 DOI:10.1186/s13018-025-06200-5

Tianyou Hu, Yujie Bian, Qiankun Wang, Tao Zhou, Hongxiang Zhou

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引用次数: 0

Abstract

Objective: Percutaneous external suturing has been proposed as an alternative approach to fascial flap fixation during anterior subcutaneous transposition for cubital tunnel syndrome (CuTS), with the aim of minimizing deep tissue disruption and reducing postoperative complications. This study compared short-term outcomes between percutaneous external fixation and traditional subcutaneous fixation of fascial flaps in CuTS surgery.

Methods: In this retrospective cohort study, 114 patients who underwent anterior ulnar nerve transposition with fascial flap coverage were enrolled between January 2020 and December 2023. Patients were grouped based on the method of fascial flap fixation: subcutaneous (n = 57) or percutaneous (n = 57). Clinical assessments-including Visual Analog Scale (VAS), Patient-Rated Ulnar Nerve Evaluation (PRUNE), and Cubital Tunnel Syndrome Functional Score-along with nerve conduction studies (CMAP, SNCV, MNCV), were performed preoperatively and at 6-month follow-up.

Results: Compared to the subcutaneous group, the percutaneous group showed significantly greater improvement in VAS scores (VAS: -2.75 vs. -1.99, p < 0.001), PRUNE scores (PRUNE: -23.78 vs. -17.64, p < 0.001), and functional scores (Score: +3.58 vs. + 2.70, p = 0.0004). Increases in SNCV (16.45 m/s vs. 14.51 m/s, p = 0.035) and MNCV (18.55 m/s vs. 12.13 m/s, p < 0.001) were also more pronounced in the percutaneous group. Although CMAP improved in both groups, postoperative CMAP values were slightly higher in the subcutaneous group (6.02 ± 0.85 mV vs. 5.40 ± 0.51 mV, p = 0.002). No infections or wound complications occurred in either group; two reoperations for recurrent compression were required in the subcutaneous group.

Conclusion: Percutaneous external suturing may represent a safe and promising alternative for fascial flap fixation during CuTS surgery, with potential benefits in early postoperative pain relief, nerve conduction, and functional outcomes. However, longer-term studies are needed to assess durability and potential late complications.

Trial registration: This study was retrospectively registered with the Institutional Review Board of the First Affiliated Hospital of Anhui Medical University (Approval No. PJ2024-12-17).

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肘管综合征手术中经皮与皮下筋膜瓣固定的短期疗效：一项回顾性队列研究。

目的：经皮外缝合作为筋膜瓣固定在肘管综合征（CuTS）前皮下转位术中的替代方法，旨在减少深部组织破坏和减少术后并发症。本研究比较了经皮外固定与传统皮下固定在切口手术中筋膜瓣的短期疗效。方法：在这项回顾性队列研究中，在2020年1月至2023年12月期间，114例接受筋膜瓣覆盖的尺前神经转位患者入组。根据筋膜瓣固定方法进行分组：皮下固定（n = 57）或经皮固定（n = 57）。临床评估-包括视觉模拟量表（VAS），患者评分尺神经评估（PRUNE）和肘管综合征功能评分-以及神经传导研究（CMAP， SNCV， MNCV），在术前和6个月的随访中进行。结果：与皮下组相比，经皮组VAS评分显著提高（VAS: -2.75 vs -1.99, p）。结论：经皮外缝合可能是CuTS手术中筋膜瓣固定的一种安全且有前景的替代方法，在术后早期疼痛缓解、神经传导和功能预后方面具有潜在的益处。然而，需要更长期的研究来评估其耐久性和潜在的晚期并发症。试验注册：本研究在安徽医科大学第一附属医院机构审查委员会回顾性注册(批准号：PJ2024-12-17)。

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

Journal of Orthopaedic Surgery and Research ORTHOPEDICS-

CiteScore

4.10

自引率

7.70%

发文量

494

审稿时长

>12 weeks

期刊介绍： Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues. Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications. JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.