Objectives: Retrospective clinical evaluation of 31 patients who underwent ulnar nerve decompression at the elbow and subcutaneous anterior transposition.
Methods: From January 2000 to December 2013, 71 patients underwent subcutaneous anterior transposition of the ulnar nerve. Thirty-one patients returned for evaluation. The mean follow-up period was 60 months. Patients were evaluated for the degree of satisfaction after surgery, paresthesia, pain, Tinel sign, Froment test and sensitivity test by esthesiometer, muscle strength of the intrinsic muscles and deep flexor of the fifth digit, visual analogic pain scale (VAS) and were subjected to the QuickDash questionnaire.
Results: Thirty-nine per cent of patients had compression on the right side and 61% on the left side. Sixty-one percent were idiopathic, 35% post traumatic and 3% had Poems syndrome. Forty-eight per cent of patients were very much satisfied after surgery and 52% were satisfied. Forty-eight per cent had paresthesia after surgery and 52% did not.
Conclusion: The ulnar neurolysis of the cubital tunnel with anterior subcutaneous transposition is a safe and effective technique for treating idiopathic or post-traumatic compressive neuropathy, with high success rate and excellent function for activities of daily living. Level of Evidence IV, Case Series.
Objetivo: O objetivo desse estudo é avaliar os resultados funcionais de pacientes submetidos a tratamento cirúrgico de lesões completas do ligamento colateral ulnar do polegar (LCU) com âncoras. Método: estudo retrospectivo por meio da avaliação funcional de 15 pacientes submetidos a tratamento cirúrgico de lesões completas do LCU com âncoras. Foram avaliados idade, gênero, ocupação, mão dominante, tempo entre a lesão e a cirurgia, mecanismo de trauma e tempo de seguimento, amplitude de movimento, forças de pinça e preensão e teste de estabilidade em valgo. Foi aplicado questionário DASH (Disabilities of the Arm, Shoulder and Hand) para avaliar disfunções e sintomas dos pacientes submetidos ao tratamento cirúrgico. Resultado: Nenhum paciente apresentou instabilidade após o tratamento cirúrgico. O tempo de seguimento médio foi de 52 meses. Em comparação com a literatura, observamos maior força de pinça do polegar e menor valor de amplitude de extensão da metacarpo-falangeana, sem diferença estatisticamente significativa entre os valores da força de preensão e flexão. Conclusão: O tratamento cirúrgico das lesões de Stener do polegar com âncoras é uma opção segura, que fornece estabilidade e boa recuperação funcional. A recuperação das forças de pinça e preensão foram adequadas, promovendo boa função do polegar. O nível de dor e satisfação dos pacientes no seguimento pós-operatório foram considerados, em geral, bastante satisfatórios.
Objective: To evaluate the outcome of olecranon bone graft and compression screw for the treatment of nonunion of the Lichtman type I scaphoid.Method: We evaluated 15 patients of 32 who underwent surgical treatment for nonunion of the Lichtman type I scaphoid with olecranon bone graft and screw compression.Results: We obtained 100% consolidation in our sample. The mean flexion of the wrist on the affected side was 68° and 75° on the non-affected side. The average extension was 63° and 72°, respectively. The average grip strength was 35 kgf. This corresponds to 98% of the handgrip strength of the non-affected side, which was 37 kgf. The DASH score averaged 5 points.Conclusion: We believe that the use of bone graft obtained from the olecranon and secured with cannulated screw is a resolute technique for cases of linear nonunion of the Lichtmann type I scaphoid. It has the advantages of a new anesthesia for removal of the graft and the access is easy, providing a good exposure for removal and good aesthetic results. Level of evidence IV. Case series.
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