肌下转位矫正肘管松解术的疗效：比较结果分析

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2025-08-22 DOI:10.1016/j.jhsg.2025.100810

Joshua Riklan BS , Alexzandra Mattia BS , Markos Mardourian BS , Harvey Chim MD

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引用次数: 0

摘要

目的评估翻修后肘管松解和肌下转位的疗效，并将其与一组接受首次松解和原位减压的患者进行比较。方法16例患者行肘管松解和肌下转位翻修术。平均随访21.4个月（12.8-55.6个月）。使用密歇根手部结果问卷（MHQ）和手臂、肩膀和手的残疾（DASH）对患者进行亲自评估。Dellon分期、McGowan分级、疼痛视觉模拟量表以及使用Messina标准和改进的Bishop评分评估症状的改善情况。比较分析了一组接受原位减压的原发性患者（n = 18），平均随访26.6个月（范围13.3-63.3）。结果在翻修患者中，13例（81.3%）Dellon期术后改善，12例（75.0%）McGowan级术后改善。与主要队列相比，Messina的标准在修订中显示较差但仍令人满意的结果。修订队列的中位MHQ为57.1(48.8-79.4)，初级队列的中位MHQ为76.3（71.6-93.7）。修订队列的DASH中位数为26.3(16.1-45.3)，初级队列为11.7（5.6-14.2）。两组MHQ和DASH的差异均有统计学意义（P < 0.05）。修订队列的中位视觉模拟量表为2.5(0-6)，初级队列的中位视觉模拟量表为1.5（0-4.5）。结论经肘管松解和肌下转位翻修的患者，大部分症状得到缓解。然而，与接受首次释放的患者相比，改善是不完全的和较差的。研究类型/证据水平：治疗性

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Efficacy of Submuscular Transposition for Revision Cubital Tunnel Release: Comparative Outcomes Analysis

Purpose

To assess outcomes after revision cubital tunnel release and submuscular transposition and compare these to a cohort of patients undergoing primary release with in situ decompression.

Methods

Patients who underwent revision cubital tunnel release and submuscular transposition (n = 16) were enrolled. Mean follow-up was 21.4 months (range 12.8–55.6). Patients were evaluated in person using the Michigan Hand Outcomes Questionnaire (MHQ) and Disabilities of the Arm, Shoulder and Hand (DASH). Dellon stage, McGowan grade, visual analog scale for pain, and improvement of symptoms using the Messina’s criteria and Modified Bishop score were assessed. Comparative analysis was performed with a cohort of primary patients who underwent in situ decompression (n = 18), with a mean follow-up of 26.6 months (range 13.3–63.3).

Results

In revision patients, postoperative improvement in Dellon stage was seen in 13 (81.3%) and McGowan grade in 12 (75.0%). Messina’s criteria showed inferior but still satisfactory outcomes in the revision compared to primary cohort. Median MHQ was 57.1 (48.8–79.4) in the revision cohort and 76.3 (71.6–93.7) in the primary cohort. Median DASH was 26.3 (16.1–45.3) in the revision cohort and 11.7 (5.6–14.2) in the primary cohort. Differences between MHQ and DASH in both cohorts were statistically significant (P < .05). Median visual analog scale was 2.5 (0–6) in the revision cohort and 1.5 (0–4.5) in the primary cohort.

Conclusions

The majority of patients undergoing revision cubital tunnel release and submuscular transposition have relief of symptoms. However, improvement is incomplete and inferior compared to patients undergoing primary release.