| 摘要 |
Objective: Anterior subcutaneous transposition of the ulnar nerve is one of the
accepted treatments for cubital tunnel syndrome, but it is often performed under
general or regional anesthesia. We have analyze our experience with less invasive
local anesthesia for this procedure.
Methods: We retrospectively reviewed the records of 51 patients (53 elbows)
undergoing anterior subcutaneous transposition of the ulnar nerve under local
anesthesia between January 1999 and June 2005. The elbows were assessed both
clinically and electrophysiologically. A modification of the McGowan classification
was used preoperatively, and Amadio's classification, consisting of four grades
(excellent, good, fair and poor) based on a 9-point rating scale, was used
postoperatively to assess the results. Excellent and good grades were considered
significant improvement, while fair and poor were considered no significant
improvement.
Results: Preoperatively, of the 53 elbows, 13 were classified as grade I, 16 as grade
IIA, 14 as grade IIB, and 10 as grade III. Significant improvement was achieved in 39
(74%), and 42 (79%) were at lest one grade better after surgery. The outcome was
correlated with the pre-operative McGowan and electrophysiologic grading. All
patients tolerated the procedure well, and 90% of them would again choose to have
the operation performed under local anesthesia.
Conclusions: Anterior subcutaneous transposition of the ulnar nerve can be
performed reliably and effectively under local anesthesia. This has benefits in
avoiding the potential complications of regional or general anaesthesia, especially in a
group of elderly patients who are poor-risk, and it can be considered as an option for
surgical management of ulnar nerve entrapment. |
