[Effectiveness comparison between two different methods of anterior transposition of the ulnar nerve in treatment of cubital tunnel syndrome].

OBJECTIVE

To compare the effectiveness of anterior subcutaneous transposition and anterior submuscular transposition of the ulnar nerve in the treatment of cubital tunnel syndrome.

METHODS

Between June 2006 and October 2008, 39 patients with cubital tunnel syndrome were treated separately by anterior subcutaneous transposition (anterior subcutaneous transposition group, n = 20) and anterior submuscular transposition (anterior submuscular transposition group, n = 19). There was no significant difference in gender, age, duration, and clinical classification between 2 groups (P > 0.05).

RESULTS

All incisions healed by first intention in 2 groups. In anterior submuscular transposition group, 17 patients (89.5%) had abruptly deteriorated symptoms after the symptom of ulnar nerve compression was abated, and 1 patient (5.3%) had cicatrix at elbow; in the anterior subcutaneous transposition group, 10 patients (50.0%) had disesthesia at cubital anterointernal skin after operation; and there was significant difference in the complication between 2 groups (chi2 = 9.632, P = 0.002). The patients were followed up 24 to 36 months, 28 months on average. There was no significant difference in grip strength, pinch power of thumb-to-ring finger and thumb-to-little finger, or two-point discrimination of distal little fingers between 2 groups (P > 0.05), but significant differences were found between before operation and after operation in 2 groups (P < 0.05). According to the Chinese Medical Society of Hand Surgery Trial upper part of the standard evaluation function assessment, the results were excellent in 5 cases, good in 12 cases, fair in 1 case, and poor in 2 cases in the anterior subcutaneous transposition group; the results were excellent in 6 cases, good in 10 cases, fair in 2 cases, and poor in 1 case in the anterior submuscular transposition group; and there was no significant difference between 2 groups (u = 0.346, P = 0.734). According to disability of arm-shoulder-hand (DASH) questionnaires, the score was 22 +/- 7 in anterior subcutaneous transposition group and was 19 +/- 6 in anterior submuscular transposition group, showing no significant difference (t = 1.434, P = 0.161).

CONCLUSION

Both anterior subcutaneous transposition and anterior submuscular transposition have good effectiveness in treating cubital tunnel syndrome; and anterior submuscular transposition has less complication than that of submuscular transposition.