肘部管症候群の手術成績

Abstract

In general for cases of osteoarthritis of the elbow with cubital tunnel syndrome we perform anterior transposition of the ulnar nerve for cubital valgus and the modified King's procedure, that is medial epicondylectomy with neurolysis of the ulnar nerve.From 1984 to 1993, 57 elbows with cubital tunnel syndrome were treated by modified King's procedure in 45 elbows, by submuscular transposition of the ulnar nerve in 7 elbows and by subcutaneus transposition of the ulnar nerve in 5 elbows. The duration of follow-up was 1 to 9.7 years (mean 4.7 years) after surgery. Results were as follows: excellent, 15; good, 32; fair, 6; poor, 4 according to Akahori's criteria. The results depended on the severity. That is, all cases of stage I and II according to Akahori's classification had excellent or good results, but did not depend on duration of their symptoms. As regard to anterior transposition of the ulnar nerve, both submuscular and subcutaneous transposition achieved good results and there is not a difference between submuscular and subcutaneous transposition. The factors of fair and poor results were combined into cervical spondylotic myelopathy and insufficiency of bone resection and stage IV in Akahori's classification.