Early Electrophysiological Changes After Using PDLLA Film In The Subcutaneous Anterior Transposition Of Ulnar Nerve

Introduction:Excessive fibrosis and scarring in the surgical region may lead to nerve adhesion and compression,thus affect the effect of surgery.With the development of science,various bio-material has been invented to inhibit adherence of peripheral nerves.PDLLA is a new biodegradable polymer,with good biocompatibility and plasticity,high intensity.It is decomposed by enzyme in human body to carbon dioxide and water eventually.We followed up the electromyograms of 34 patients with cubital tunnel syndrome,to observe the early electrophysiological changes after using PDLLA film in the subcutaneous anterior transposition in ulnar nerve.Obeetive:To observe the early electrophysiological changes after using PDLLA film in the subcutaneous anterior transposition in ulnar nerve.Method:From 2007 December to 2008 December,we collected 34 patient with cubital tunnel syndrome.22 were male and 12 were female.13 people were affected in their left side,19 right side and 2 patients had complaints on both sides.10 of them had syndromes which reflected the compression of ulnar nerve after trauma of their elbows(4 in observed group,6 in control group).24 patients had syndromes with no obvious cause(14 in observed group,10 in control group).The ages ranged from 7 years old to 77 years old,46.3 averagely.The course of disease ranged from 3 months to 3 years.All of the patients underwent the decompression of ulnar nerve at elbow and subcutaneous anterior transposition of the nerve.In the operation,nerves of 19 cases were wrapped by a PDLLA film.The follow-up time ranged from 2 months to 15 months.The follow-up content was to collect elcetromyogram of the patients before and after operation.We compared the nerve conduction velocities from 5cm above elbow to 5cm below elbow and the wave amplitudes of CMAP which were educed in abductor digiti minimi after stimulating the ulnar nerve at elbow before and after the operation.Results:The nerve conduction velocities from 5cm above elbow to 5cm below elbow had improvement in both groups.There was 1 in the control group and 3 in the observed group that CMAP can't be educed in the abductor digiti minimi,and the nerve conduction velocities were 0 before operation.These patients had certain improvements after operations.The rest patients showed that:in the control group, MNCV improved about 43%averagely;in the observed group,MNCV improved about 58.7%.However,there was no statistically differences between them totally. The amplitudes of CMAP which were educed in abductor digiti minimi improved about 54.6%averagely in the control group,while it improved about 108.3%in the observed group.Totally,there was statistical differences between two groups in this aspect.Conclusion:PDLLA film had some electrophysiological effect in the early period of subcutaneous anterior transposition in ulnar nerve.