Endoscopic versus open in situ decompression for the management of cubital tunnel syndrome

IF 1.1 4区医学 Q3 ORTHOPEDICS

Acta orthopaedica et traumatologica turcica Pub Date : 2022-03-01 DOI:10.5152/j.aott.2022.21143

Tahir Öztürk, E. Zengin, U. Şener, M. Şener

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引用次数: 1

Abstract

Objective: This study aimed to compare the results of endoscopic in situ decompression (EISD) versus open in situ decompression (OISD) in the management of cubital tunnel syndrome (CUTS). Methods: In this retrospective study, 32 patients who underwent either OISD or EISD for the treatment of CUTS between 2012 and 2019 were identified and divided into one of the two groups: Group I consisted of 13 patients undergoing EISD and group II consisted of 19 patients receiving OISD. Patients were queried regarding the presence of preoperative and postoperative paresthesia. Electromyography (EMG) was performed on all patients preoperatively and at the final control. Preoperative and postoperative pain with palpation were evaluated over the cubital tunnel. The Dellon classification was used for preoperative evaluation of patient symptoms, and the Bishop classification was used for postoperative evaluation. Hand grip strength was measured with a dynamometer. At the preoperative and postoperative final follow-up, the palmar, key, and tip pinches were measured with a pinchmeter. The surgical incision length was measured with a ruler at the end of the operation in all patients. The operation duration was recorded as the time interval between the beginning of the incision and the end of the tourniquet. Results: The overall mean age was 43.8 (range; 22 to 66) years. Nine patients were female, and 23 patients were male. No Dellon I patients were present in either group. Overall, 68.75% of the patients were Dellon II and 31.25% were Dellon III. According to the Bishop score, excellent and good results were obtained in 84.6% of the patients in Group I and 73.7% of the patients in Group II. The final follow-up examination found continued paraesthesia in 6 (18.75%) patients. Comparison of the improvement in the postoperative NCV value showed a statistically significantly superior improvement in Group I compared to Group II. The postoperative palmar pinch and tip pinch tests results were statistically significantly better in group I than in group II. Conclusion: Although EISD had better results clinically, no statistically significant difference was found between the two techniques in terms of Bishop scores and complications. Examination of the electrophysiological results suggested a better outcome in patients who underwent EISD. Level of Evidence: Level III, Therapeutic Study

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内窥镜与开放式原位减压治疗肘管综合征

目的:本研究旨在比较内镜下原位减压(EISD)与开放式原位减压(OISD)治疗肘管综合征(CUTS)的效果。方法:在本回顾性研究中，选取2012年至2019年期间接受OISD或EISD治疗的32例患者，并将其分为两组:I组包括13例接受EISD的患者，II组包括19例接受OISD的患者。询问患者术前和术后有无感觉异常。所有患者术前及最终对照组均行肌电图(EMG)检查。术前和术后用触诊法评估肘管疼痛。术前采用Dellon分类评估患者症状，术后采用Bishop分类评估患者症状。用测力仪测量了手握力。在术前和术后的最后随访中，用捏尺测量掌、键和尖的捏度。所有患者在手术结束时用尺子测量手术切口长度。手术时间记录为切口开始至止血带结束的时间间隔。结果:患者总体平均年龄43.8岁(范围;22至66岁。女性9例，男性23例。两组均无delon I型患者。总体而言，Dellon II型占68.75%，Dellon III型占31.25%。根据Bishop评分，I组患者的优良率为84.6%，II组患者的优良率为73.7%。最终随访检查发现6例(18.75%)患者持续感觉异常。术后NCV值改善的比较显示，I组的改善明显优于II组。术后掌捏、指尖捏试验结果I组优于II组，差异有统计学意义。结论:虽然EISD的临床效果较好，但两种方法在Bishop评分和并发症方面无统计学差异。电生理检查结果表明，接受EISD的患者预后较好。证据等级:III级，治疗性研究

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来源期刊

Acta orthopaedica et traumatologica turcica ORTHOPEDICS-

CiteScore

2.00

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Acta Orthopaedica et Traumatologica Turcica (AOTT) is an international, scientific, open access periodical published in accordance with independent, unbiased, and double-blinded peer-review principles. The journal is the official publication of the Turkish Association of Orthopaedics and Traumatology, and Turkish Society of Orthopaedics and Traumatology. It is published bimonthly in January, March, May, July, September, and November. The publication language of the journal is English. The aim of the journal is to publish original studies of the highest scientific and clinical value in orthopedics, traumatology, and related disciplines. The scope of the journal includes but not limited to diagnostic, treatment, and prevention methods related to orthopedics and traumatology. Acta Orthopaedica et Traumatologica Turcica publishes clinical and basic research articles, case reports, personal clinical and technical notes, systematic reviews and meta-analyses and letters to the Editor. Proceedings of scientific meetings are also considered for publication. The target audience of the journal includes healthcare professionals, physicians, and researchers who are interested or working in orthopedics and traumatology field, and related disciplines.