The Clinical Analysis Of Cubital Tunnel Syndrome

Objective：To analyze the etiology, diagnosis and treatment methods,typethe disease by the pathological changes in operation,so as to provide basisfor the selection of surgical treatment and the assessment of prognosis.Methods： One hundred and seventy-one cases of cubital tunnelsyndrome treated in our hospital from January2008to December2011were reviewed.Among one hundred and seventy-one patients,one hundredand seventeen males and fifty-four females with an average age of47.81±13.98（range,15-77）years,The average course of disease was15.18±23.85（range,0.3-180）months，twenty-eight cases had history ofwound at the elbow,fourteen cases had cysts,thirty-one cases had cubitusvalgus,twenty-five cases had osteoarthritis,three cases had arthrous loosebodies,seventy cases had no clear causes.Among the cases,one hundredand sixty-seven patients with treatment of operation,of them simpleulnar neurolysis performer33cases,traditional subcutaneous transpositionperformer85cases,fasia transposition performer41cases,intramusculartransposition performer4cases,submuscular transposition performer4cases;epineurium neurolysis in61cases,perineurium neurolysis in13cases;type them according to the intraoperative neural changes,sevencases of type Ⅰ,forty-seven cases of type Ⅱ,seventy-five cases of typeⅢ,thirty-eight cases of type Ⅳ.Results：One hundred and nine patients were followed-up for1-5yearswith an average of3years.According to the function evaluation trialstandards of upper limb peripheral nerve from the Hand SurgeryOrganization of Chinese Medical Association,Excellent outcomes wereobtained in forty-six(typeⅠ6cases,typeⅡ35cases,typeⅢ5cases),good in forty-five(type Ⅲ36cases,type Ⅳ9cases) and fair in seventeen(typeⅢ2cases,type Ⅳ15cases)patients. Results were rated as poor in onecases(type Ⅳ).Conclusion：Cubital tunnel syndrome with the peak incidence occurringin male patients aged40-60years old;The prognosis is closely related tothe preoperative disease severity,once diagnosed,should be operatedearly;Intraoperative classification helps to choose operative method andprospect prognosis;Severe cubital tunnel syndrome patients with clawfingers,nerve release and the intrinsic muscle of hand functionreconstruction are suggested.