[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.