Ömer Naci ERGİN, Necmettin TURGUT, Serkan BAYRAM, Mehmet DEMİREL, Murat ALTAN, Ahmet SALDUZ, Hayati DURMAZ

KÜBİTAL TÜNEL SENDROMUNDA ANTERİOR TRANSPOZİSYON İLE İN SİTU GEVŞETMENİN FONKSİYONEL VE ELEKTRODİAGNOSTİK SONUÇLARININ KARŞILAŞTIRILMASI

Amaç: Bu çalışmanın amacı, kübital tünel sendromu olan hastalarda in situ gevşetme ve anterior transpozisyon prosedürlerinin klinik ve elektrodiagnostik sonuçlarının karşılaştırılmasıdır. Gereç ve Yöntemler: Çalışmamıza preoperatif ve postoperatif elektromiyogram (EMG) sinir iletim testi olan düzenli takip uygulanan 34 hastanın 20’si dahil edildi. Hastalar in situ gevşetme (A grubu) ve anterior transpozisyon (B grubu) olarak 2 gruba ayrıldı. Her iki grup modifiye Bishop fonksiyonel skorları, preoperatif ve postoperatif EMG parametreleri kullanılarak karşılaştırıldı. Bulgular: İki grup arasında EMG parametrelerinin ilişkisi açısından istatistiksel olarak anlamlı fark saptanmadı. Preoperatif ve postoperatif EMG sonuçları karşılaştırıldığında, anterior transpozisyon uygulanan grupta “dirsek- dirsek altı” ve “dirsek altı-el bileği” motor iletkenlik hızının anlamlı olarak arttığı saptandı (p=0,018 ve 0,04). Bishop skoru A grubunda ortalama 7,9 iken, B grubunda 9,3 olarak saptandı. Bishop skorları açısından iki grup arasında istatistiksel olarak anlamlı fark saptanmadı. Sonuç: Kübital tünel sendromunun tedavisinde, teknik seçimi fonksiyonel sonuçları etkilememektedir; Bununla birlikte, sinirin anterior transpozisyonu, “dirsek- dirsek altı” ve “dirsek altı-el bileği” motor iletim hızında daha fazla iyileşme sağladığı saptandı.

Anahtar Kelimeler:

Ulnar sinir, EMG, Anterior transpozisyon

ANTERIOR TRANSPOSITION VERSUS IN SITU NEUROLYSIS IN CUBITAL TUNNEL SYNDROME: A COMPARISON BASED ON FUNCTIONAL AND ELECTRO-DIAGNOSTIC EVALUATION

Objective: The aim of the present study is to compare that results of in situ neurolysis and anterior transposition procedures both clinically and electro-diagnostically in those patients diagnosed with cubital tunnel syndrome. Material and Methods: Twenty of 34 patients who had undergone both preoperative, postoperative electromyogram (EMG) nerve conduction tests and regular follow-up were included in our study. Then, the patients were divided into 2 groups - in situ neurolysis (group A) and anterior transposition (group B). Both groups were compared based on modified Bishop functional scores, preoperative and postoperative EMG parameters. Results: There was no statistically significant difference in relation to EMG parameters between the two groups. When comparing preoperative and postoperative EMG results, in the patients with anterior transposition surgery ‘elbow to below-elbow’ and ‘below-elbow to wrist’ motor conduction velocity was increased significantly (p=0.018 and 0.04). While the average Bishop score was 7.9 in group A and 9.3 in group B, there was no statistical difference between the two groups in terms of Bishop Scores. Conclusion: In the management of cubital tunnel syndrome, the choice of technique doesn’t affect the functional results; however, anterior transposition of the nerve provides better recovery in ‘elbow to below-elbow’ and ‘below-elbow to wrist’ motor conduction velocity.

Keywords:

Ulnar nerve, EMG, Anterior transposition,

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