Abstract
From 1996 to 2000, we reoperated nine patients totally dissatisfied after previous surgery for cubital tunnel syndrome. All patients had simple external neurolysis in situ of the transposed ulnar nerve. Only the anterior aspect of the ulnar nerve was dissected and released. Dense scarring around the ulnar nerve was found to be the main cause of recurrence but could not explain the three initial cases of persistent symptoms. All patients were reviewed 2 years after the secondary neurolysis. The patients were asked to describe their remaining symptoms and examination included palpation of the ulnar nerve at the elbow, Tinel’s sign, two-point discrimination, and palpation of the scar. Pinch and grip strength were measured. According to the Wilson and Krout classification, there were four good results with complete alleviation of symptoms, four fair results, and one poor result. Simple neurolysis proved to be effective after failed anterior submuscular transposition of the ulnar nerve at the elbow.
Résumé
De 1996 à 2000, nous avons réopéré neuf malades, pour échec de chirurgie antérieure pour syndrome du tunnel cubital. Tous les malades ont eu une neurolyse simple, in situ, du nerf ulnaire transposé. Seule la face antérieure du nerf ulnaire a été disséquée et libérée. Une cicatrice dense autour du nerf a été trouvée comme étant la cause principale de récidive mais ne pouvait pas expliquer les trois cas initiaux de persistance des symptomes. Tous les malades ont été examinés deux ans après la neurolyse secondaire. On leur a demandé de décrire leurs symptômes restants et l’examen incluait la palpation du nerf ulnaire au coude, la recherche du signe de Tinel, de la discrimination de deux points et la palpation de la cicatrice. La force de pincement et la force de la prise ont été mesurées. D’après le classification de Wilson et Krout, il y avait quatre bons résultats avec complète disparition des symptômes; quatre résultats moyens et un mauvais résultat. La simple neurolyse à prouvé être efficace après l’échec de la transposition submusculaire antérieure du nerf ulnaire au coude.
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