The Anatomic Study And Clinic Application Of Treatment Of Cubital Tunnel Syndrome By The“Two Points” Acupotomology Surgery Program

Objective:By studying the anatomy of the elbow, to design a acupotomology surgery program which is meeting the anatomy,operated easily and having the satisfactory Efficacy. Methods:Anatomical study:12 sides of 6 adult cadaveric upper limb specimens perfused with red latex and anticorrosion fixed in Artery.according to the normal anatomical method to find the ulnar nerve,observe the Cubital tunnel structure, supply of ulnar nerve nutritionblood vessel, the position of Osborne’s ligament and the elastic state of Osborne’s ligament when stretching elbow and buckling elbow. Measure the length, width and thickness of the arcuate ligament,Cubital tunnel area and The ulnar nerve area And then according to pathogenic factors and elbow anatomy to design a “two points” acupotomology surgery program.clinical research:use the “two points” acupotomology surgery program to treat 21 patients of cubital tunnel syndrome from September 2012 to January 2014.use the Chinese society of hand surgery of ulnar nerve function evaluation trial standards to Score of the 21 patients, using the Spass11.0 to our statistical analysis and then observed the efficacy Results:The results of anatomy:the cubital nerve passes through the cubital tunne which Enclosed by the flexor carpi ulnaris of head of humerus and ulna olecranon fibrous connective tissue(arcuate ligament) and The ulnar groove of humerus at the elbow.12 sides of elbow all have Osborne’s ligament, Osborne’s ligament is the posterior wall of the cubital tunnel. It is the continuation of aponeurotic fascia of forearm.It is began from the condylus medialis humeri,and stoped at the aponeuroses of cubitalis anterior and the tip of olecroanon.The direction of its fiber is roughly perpendicular to the fascia of cubitalis anterior.The width of Osborne’s ligament is 0.97 ± 0.23 cm, the length of Osborne’s ligament is 1.41±0.42 cm and the thickness of Osborne’s ligament is 0.05±0.01 cm. The proximal margin of the Osborne’s ligament was pulled into a clearly visible fiber inclined outward the uplift when buckling the elbow.The Osborne’s ligament was relaxed state when Stretch the elbow joint.The blood supply of the ulnar nerve come from the superior ulnar collateral artery, the inferior ulnar collateral artery and the ulnar recurrent artery.They are related to the ulnar nerve accompanied. Superior ulnar collateral artery 3-6 neural nutrition branch of ulnar nerve, inferior ulnar collateral artery 1-2 neural nutrition branch of ulnar nerve, the dorsal branch of ulnar recurrent artery by 2-4 nerve branch of the ulnar nerve nutrition.But at the elbow and ulnar nerve accompanying vessels only superior ulnar collateral artery and the ulnar recurrent artery.At the elbow, cubital tunnel section area of the ulnar nervewas 0.138 ± 0.019cm2,Cubital tunnel area is 0.244 ± 0.046cm2.Clinical study results:Ulnar nerve function score: after using the “two points” acupotomology surgery program to treat the cubital tunnel syndrome,the Finger flexion and ulnar nerve innervation area of feeling has significant difference(P﹤0.01),and the hand shape also has significant difference(P﹤0.05) Conclusion:1.The ratio of the cubital tunnel nerve area and cubital tunnel area is 1:1.77.There are little difference between the ulnar nerve area and the Cubital tunnel area.The Cubital tunnel area is smaller when you bend your elbow, because the arcuate ligament is tightened.And then the ulnar nerve in the cubital tunnel pressure easily.2.The “two points”acupotomology surgery program which we designed cut the starting and ending points of Osborne’s ligament to solve the problem of ulnar nerve entrapment.Evaluation of the clinical application of this function after surgery is good, curative effect satisfaction.It is confirmed that the “two points ” acupotomology surgery program is meeting the anatomy,operated easily and having the satisfactory Efficacy.