주관 증후군의 수술적 치료: 척골 신경의 전방 근하 전위술과 전방 근막하 전위술의 비교

• Published in: 대한미세수술학회지 Vol. 17; no. 1; pp. 36 - 41
• Main Authors: 강수환, 송석환, 박일중, 이상욱, 이승구, 박승범, Kang, Soo-Hwan, Song, Seok-Whan, Park, Il-Jung, Lee, Sang-Uk, Rhee, Seung-Koo, Park, Seung-Bum
• Format: Journal Article
• Language: Korean
• Published: 2008
• Subjects: Cubital tunnel syndrome; Anterior subfascial transposition; Anterior submuscular transposition
• ISSN: 1226-2706; 2288-2480

Surgical treatment of compressive ulnar neuropathy at the elbow has been performed with a wide variety of techniques. Among these techniques, anterior submuscular transposition of the ulnar nerve has been regarded as the method of choice by many authors. It has many advantages including a low recurrence rate, scar-free vascular bed, and protection from repeated trauma to the nerve. However, anterior submuscular transposition is technically demanding and requires more extensive soft tissue dissection. On the other hand, anterior subfascial transposition is less invasive, requires a relatively shorter operation time than the submuscular technique, and also can be done safely even in patiensts with elbow arthritis. We evaluated the clinical results of anterior submuscular transposition compared with anterior subfascial transposition. Fifteen patients underwent anterior submuscular transposition and ten patients underwent anterior subfascial transposition of the ulnar nerve. The mean follow-up time was 15 months (range 10 to 38 months) in the anterior submuscular transposition group and 7 months (range 6 to 15 months) in the anterior subfascial transposition group. According to the outcome status determination algorithm devised by Mowlavi, 3 patients (20%) showed total relief, 10 patiensts (66.7%) improvement and 2 patients (13.3%) no changes in the anterior submuscular transposition group. In the anterior subfascial transposition group, 2 patients (20%) showed total relief, 7 patients (70%) improvement and 1 patient (10%) displayed no changes. Statistically there was no significant difference of the clinical results between the two surgical techniques. Therefore we would suggest anterior subfascial transposition of the ulnar nerve as a preferred method for treatment of cubital tunnel syndrome.