肘部管症候群の治療成績 皮下前方移動術とＫＩＮＧ変法について

Abstract

From 1978 to 1991, we treated 77 patients with cubital tunnel syndrome using either an anterior subcutaneous transposition or a modified King's method. 34 patients with 34 cubital tunnel syndromes were followed-up for more than 1 year. Their preoperative stages were graded by Akahori's system from stages I to V. Nerve conduction studies were performed on all the patients at follow-up. The patients' postoperative recoveries were evaluated by Akahori's post-operative stages, which were classified into 4 categories from excellent to poor.All the cases, whose preoperative stages were I to III, were graded excellent but none of the patients with a preoperative stage V had recovered to a better stage than good at follow up, regardless of the surgical procedure or the duration of numbness of the ulnar nerve distribution. The preoperative stage of cubital tunnel syndrome showed a significant correlation with the prognosis, that is, the better the preoperative stage promised to be the better the post operative recovery was. However, the duration of numbness which we thought would correlate well with the severity of the disease did not correlate with the post operative recovery. Numbness is a subjective sign and there may be differences in how individuales feel the numbness threshold.We would like to conclude from this clinical reseach that the most important factor which affects the prognosis is the preoperative stage.