Effect Of Subcutaneous Ulnar Nerve Preposition Combined With Electrical Stimulation Of Ulnar Nerve During Operation

Objective:To explore the effect of ulnar nerve subcutaneous preposition combined with intraoperative ulnar nerve electrical stimulator in the treatment of cubital tunnel syndrome(Cu TS).Methods:From January 2020 to March 2022,37 patients with cubital tunnel syndrome who met the inclusion criteria were selected in our Department of bone microsurgery.According to the time of admission,19 patients were selected as control group and 18 patients were selected as stimulation group.The control group received subcutaneous ulnar nerve preposition at the elbow alone,and the stimulation group received subcutaneous ulnar nerve preposition at the elbow combined with intraoperative electrical stimulation of the ulnar nerve.The stimulation frequency was 3.5Hz,and the stimulation intensity was determined to cause obvious contraction of the innervated muscle,and the stimulation time was 10 minutes.The two groups were followed up at 2 and 6 months,respectively.The changes of finger skin numbness on the affected side were compared between the two groups before and after surgery.Changes of grip strength of affected hand before and after operation;Changes of two-point discernment of finger skin on affected side before and after operation;Changes of claw hand before and after operation;The muscle strength of the interosseous muscle and the adductor pollicis muscle of the affected hand was Wartenberg sign and Fromant sign,respectively.The degree of atrophy of minnothenar muscle,first interosseous dorsal muscle and adductor pollicis muscle in the affected hand before and after surgery.Results:After treatment,the grip strength of the affected hand in the two groups was significantly improved at the 6-month follow-up after surgery,and there was no significant change at the 2-month follow-up after surgery.The grip strength of the stimulation group and the control group was statistically analyzed at 2 and 6 months after surgery,and there was no statistical significance in the two groups(P > 0.05).Two-point discrimination of finger skin on the affected side of the two groups was improved at 2 and 6 months after the operation,and the stimulation group was significantly improved than the control group.Statistical analysis of the stimulation group and the control group at 2 and 6 months after the operation showed that the two-point discrimination of the two groups was statistically significant(P < 0.05).The(acceptable/poor)ratio of the affected hand atrophy in both groups was significantly higher than that before surgery at 6 months after surgery,and there was no change at 2months after surgery.Statistical analysis of the stimulation group and control group at 2 months and 6 months after surgery showed no statistical significance in the improvement of the affected hand atrophy in both groups(P > 0.05).The symptoms of finger numbness on the affected side of the two groups were significantly improved at 2 months and 6 months after the operation,and the symptoms of finger numbness in the stimulation group were significantly improved than those in the control group.Statistical analysis was performed at2 months and 6 months after the operation of the stimulation group and the control group,and the improvement of the symptoms of skin numbness in the two groups was statistically significant(P < 0.05).The(acceptable/poor)ratio of the affected hand in both groups was significantly higher than that before surgery at 6 months ’follow-up after surgery,and there was no change at 2months’ follow-up after surgery.Statistical analysis of the stimulation group and control group at 2 months and 6 months after surgery showed no statistical significance in the change of the affected hand in the two groups(P > 0.05).The muscle strength of the interosseus muscle and the adductor polis polis on the affected side of the hand in both groups was improved at 2 months and 6 months after the operation,and the muscle strength of the interosseus muscle and the adductor polis polis in the stimulation group was significantly improved than that in the control group.Statistical analysis of the stimulation group and the control group at 2 months and 6 months after the operation showed no statistical significance in the improvement of the muscle strength of the interosseus muscle and the adductor polis polis in the two groups(P>0.05).During the follow-up period,1 patient in the control group received ulnar nerve release after symptom aggravation.Conclusion:Subcutaneous ulnar nerve preposition combined with intraoperative electrical stimulation of ulnar nerve in the treatment of cubital tunnel syndrome has obvious advantages over simple subcutaneous ulnar nerve preposition in improving skin numbness and skin two-point discrimination.