Objective: To investigate the clinical therapeutic effect of the ulnar neurolysis and nerve anterior transposition with an immediate range of motion for the cubital tunnel syndrome in the aged.
Methods: Forty-three patients (24 males and 19 females, aged 60-81 years, averaged 67) admitted for the cubital tunnel syndrome from January 1999 to December 2004 were randomly divided into 2 groups: Group A (n=20) and Group B (n=23), with an illness course of 2-10 months. All the patients underwent the ulnar neurolysis and the nerve anterior transposition. After operation the patients' elbows in group A were immobilized with the plaster slab for an external fixation for 3 weeks; the patients' elbows in group B did not use the external fixation, but began an immediate range of motion on the 2nd day after operation. The Bishop scoring system was used to evaluate the patients' functional recovery in the 2 groups.
Results: The follow-up for 1-5 years showed that the ulnar nerve function of all the patients were improved but no significant differences were found between the 2 groups (P > 0.05). The patients in Group A returned to daily activities or work at 45.2 +/- 5.1 days, but the patients in Group B required 15.5 +/- 3.8 days, with a significant difference between the 2 groups (P < 0.05). According to Bishop scoring system, the results were excellent in 14 cases, good in 4 cases, fair in 1 case and poor in 1 case in Group A, and 16, 4, 2 and 1 respectively in Group B. There was no significant difference between the two groups (P > 0.05).
Conclusion: The ulnar neurolysis and nerve anterior transposition with an immediate range of motion for the cubital tunnel syndrome can promote the ulnar function recovery of the old-aged patients. They can return to their daily activities or work at a more rapid speed when their elbows are mobilized immediately after operation.