ANTEPOSITION OF THE ULNAR NERVE IN THE TREATMENT OF CUBITAL TUNNEL SYNDROME

Cilj istraživanja: Cilj je rada ispitati uspješnost dekompresije ulnarnog živca u kubitalnom kanalu s istovremenom antepozicijom tako što će se usporediti klinička slika prije operacijskog zahvata i nakon njega. Uspješnost operacijskog zahvata podrazumijeva povećanu pokretljivost, poboljšanje senzibiliteta i motorike te smanjenje intenziteta bolova u inervacijskom području ulnarnog živca, kao i promjene u kontrolnom EMNG nalazu. Nacrt studije: Istraživanje je ustrojeno kao retrospektivno-prospektivna studija. Uključeno je 19 pacijenata, od toga 10 muškaraca i 9 žena. Materijali i metode: Za potrebe istraživanja koristili su se podatci iz povijesti bolesti pacijenata, koji su prikupljeni iz medicinske dokumentacije Zavoda za ortopediju KBC-a Osijek. Prikupljeni podatci poslužili su za provjeru uspješnosti kirurške metode antepozicije ulnarnog živca u liječenju sindroma kubitalnog kanala. Analizirani podatci bili su: spol, dob, zahvaćena strana, prisutnost parestezija (Tinelov znak) i motoričke slabosti (Fromentov znak), te klasifikacija stadija sindroma kubitalnog kanala prema Dellonovoj klasifikaciji. Rezultati: Medijan dobi pacijenata u vrijeme operativnog zahvata bio je 35 godina. U uzorku od 19 pacijenata, njih 15 postiglo je poslijeoperativno poboljšanje kliničke slike u obliku poboljšanja i jačanja motorike inerviranih mišića i smanjenja intenziteta senzornih ispada na području inerviranom od strane ulnarnog živca. Kod preostala 4 pacijenta klinička slika nije se promijenila u odnosu na preoperativno razdoblje i nije postignut nikakav napredak u vidu smanjenja simptomatike sindroma kubitalnog kanala. Zaključak: Kirurškom metodom antepozicije ulnarnog živca postignut je statistički značajan napredak u liječenju sindroma kubitalnog kanala.Objectives: The aim of this study was to evaluate the success rate of decompression of the ulnar nerve in the cubital canal with simultaneous anteposition, by comparing the clinical results before and after the surgical procedure. The success of the surgical procedure includes increased mobility, improved sensibility and motor function along with decreased intensity of pain in the innervation area of ulnar nerve as well as changes in the control EMNG findings. Study design: The study is organized as a retrospective-prospective study. The study included 19 patients, 10 of whom were men and 9 women. Participants and methods: For the purpose of this study data taken from anamnesis and local status, which was collected from medical records of the Department of Orthopaedic Surgery, University Hospital Center Osijek, was used. The collected data was used to verify the success of surgical method of anteposition of the ulnar nerve in the cubital tunnel syndrome treatment. The analyzed data included: gender, age, affected side, the presence of paresthesia (Tinel's sign) and motor weakness (Froments sign) as well as classification stage of cubital tunnel syndrome according to Dellons scale. Results: The median age of patients at the time of surgery was 35 years. In a sample of 19 patients, 15 of them achieved postoperative clinical improvement in the form of improved and stronger muscles and motor skills of innervated muscles along with reduction in intensity of sensory loss in the area innervated by the ulnar nerve. Concerning the remaining 4 patients, the clinical picture did not change in relation to the preoperative period and their progress was not identified in the form of reduced symptomatology of the cubital tunnel syndrome. Conclusion: Statistically significant progress in the treatment of cubital tunnel syndrome was achieved by the surgical method of anteposition of the ulnar nerv