Liberação endoscópica do túnel cubital na neurite hansênica do nervo ulnar

Detalhes bibliográficos
Ano de defesa: 2022
Autor(a) principal: Sampaio, Antônio Carlos Delgado
Orientador(a): Leite, José Alberto Dias
Banca de defesa: Não Informado pela instituição
Tipo de documento: Tese
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Não Informado pela instituição
Programa de Pós-Graduação: Não Informado pela instituição
Departamento: Não Informado pela instituição
País: Não Informado pela instituição
Palavras-chave em Português:
Link de acesso: http://repositorio.ufc.br/handle/riufc/74486
Resumo: Ulnar nerve compression at the elbow is commonly called cubital tunnel syndrome, being the second most common compressive neuropathy of the upper limb, statistically second only to carpal tunnel syndrome. To better characterize the role of endoscopic cubital tunnel release in leprosy neuritis and determine whether there is an improvement in pain, sensitivity and strength with the use of this minimally invasive technique. A total of 44 endoscopic procedures for ulnar nerve decompression at the elbow were performed in patients who were previously diagnosed with leprosy neuritis. The inclusion criteria were surgical indications for ulnar nerve release and clinical treatment failure for 4 weeks in patients with cubital tunnel syndrome who had their ulnar nerve function, whether motor or sensitive, deteriorated progressively despite their receiving prednisone 1mg/kg/day and physiotherapy. For endoscopic release, the CTS Relief Kit (Linvatec. Largo, FL, USA) and a standard 4mm 30° arthroscope were used. The study included 39 patients, 29 (74.4%) males and 10 (25.6%) females. The age of the patients ranged from 12 to 64 years (33 ± 14.97). Five patients underwent bilateral release. The release demonstrated a statistically significant improvement in pain (p = 0.002), in sensitivity (p < 0.001), and in strength (p < 0.001). The best results were obtained when ulnar release was performed less than 6 months after surgery indication. None of the procedures were converted from endoscopic to open. No major complications (infection, vascular injury, and nervous injury) were reported. One patient had ulnar nerve subluxation. The endoscopic release of the ulnar nerve at the elbow in leprosy neuritis entails true and safe benefits for the patient, such as improvement in pain, sensitivity and strength.
id UFC-7_476c6f421ae2499c204e70237f15087d
oai_identifier_str oai:repositorio.ufc.br:riufc/74486
network_acronym_str UFC-7
network_name_str Repositório Institucional da Universidade Federal do Ceará (UFC)
repository_id_str
spelling Sampaio, Antônio Carlos DelgadoLeite, José Alberto Dias2023-09-27T11:57:36Z2023-09-27T11:57:36Z2022SAMPAIO, Antônio Carlos Delgado. Liberação endoscópica do túnel cubital na neurite hansênica do nervo ulnar. 2022. 53 f. Tese (Doutorado em Ciências Médico-Cirúrgicas) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2022. Disponível em: http://repositorio.ufc.br/handle/riufc/74486. Acesso em: 27 set. 2023.http://repositorio.ufc.br/handle/riufc/74486Ulnar nerve compression at the elbow is commonly called cubital tunnel syndrome, being the second most common compressive neuropathy of the upper limb, statistically second only to carpal tunnel syndrome. To better characterize the role of endoscopic cubital tunnel release in leprosy neuritis and determine whether there is an improvement in pain, sensitivity and strength with the use of this minimally invasive technique. A total of 44 endoscopic procedures for ulnar nerve decompression at the elbow were performed in patients who were previously diagnosed with leprosy neuritis. The inclusion criteria were surgical indications for ulnar nerve release and clinical treatment failure for 4 weeks in patients with cubital tunnel syndrome who had their ulnar nerve function, whether motor or sensitive, deteriorated progressively despite their receiving prednisone 1mg/kg/day and physiotherapy. For endoscopic release, the CTS Relief Kit (Linvatec. Largo, FL, USA) and a standard 4mm 30° arthroscope were used. The study included 39 patients, 29 (74.4%) males and 10 (25.6%) females. The age of the patients ranged from 12 to 64 years (33 ± 14.97). Five patients underwent bilateral release. The release demonstrated a statistically significant improvement in pain (p = 0.002), in sensitivity (p < 0.001), and in strength (p < 0.001). The best results were obtained when ulnar release was performed less than 6 months after surgery indication. None of the procedures were converted from endoscopic to open. No major complications (infection, vascular injury, and nervous injury) were reported. One patient had ulnar nerve subluxation. The endoscopic release of the ulnar nerve at the elbow in leprosy neuritis entails true and safe benefits for the patient, such as improvement in pain, sensitivity and strength.A compressão do nervo ulnar ao nível do cotovelo é comumente chamada de síndrome do túnel cubital, sendo a segunda mais comum neuropatia compressiva do membro superior, perdendo estatisticamente apenas para síndrome do túnel do carpo. Os objetivos deste estudo foram caracterizar melhor o papel da liberação endoscópica do túnel cubital na neurite hansênica e determinar se há́ melhora da dor, sensibilidade e força com esta técnica minimamente invasiva. Um total de 44 procedimentos endoscópicos para descompressão do nervo ulnar no cotovelo foram realizados em pacientes previamente diagnosticados com neurite por hanseníase. Os critérios de inclusão foram indicação cirúrgica para liberação do nervo ulnar e insucesso do tratamento clínico por 4 semanas em pacientes com síndrome do túnel cubital que sofreram deterioração progressiva da função motora ou sensitiva do nervo ulnar apesar do tratamento de 1 mg/kg/dia de prednisona e fisioterapia. A liberação endoscópica foi realizada com CTS Relief Kit (Linvatec. Largo, FL, EUA) e um artroscópio padrão de 4 mm e 30°. O estudo incluiu 39 pacientes, sendo 29 (74,4%) homens e 10 (25,6%) mulheres. A idade dos pacientes variou de 12 a 64 anos (33 ± 14,97). Cinco pacientes foram submetidos à liberação bilateral. A liberação provocou melhora estatisticamente significativa de dor (p = 002), sensibilidade (p <0,001) e força (p <0,001). Os melhores resultados foram obtidos quando a liberação ulnar foi realizada em menos de seis meses após a indicação da cirurgia. Nenhum procedimento foi convertido de endoscópico para aberto. Não foram relatadas complicações maiores (infecção, lesão vascular e lesão nervosa). Um paciente apresentou subluxação do nervo ulnar. Conclusão A liberação endoscópica do nervo ulnar no cotovelo na neurite endoscópica traz benefícios verdadeiros e seguros para o paciente, como melhora da dor, sensibilidade e força.EndoscopiaNeuropatias UlnaresHanseníaseEndoscopiaNeuropatias UlnaresHanseníaseLiberação endoscópica do túnel cubital na neurite hansênica do nervo ulnarEndoscopic release of the cubital tunnel in leprosy neuritis of the ulnar nerve.info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessporreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCLICENSElicense.txtlicense.txttext/plain; charset=utf-81748http://repositorio.ufc.br/bitstream/riufc/74486/10/license.txt8a4605be74aa9ea9d79846c1fba20a33MD510ORIGINAL2022_tese_acdsampaio.pdf2022_tese_acdsampaio.pdfapplication/pdf4741869http://repositorio.ufc.br/bitstream/riufc/74486/9/2022_tese_acdsampaio.pdf16a2f4715c8d1f67db4beadddcba1addMD59riufc/744862023-09-27 08:58:27.61oai:repositorio.ufc.br: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Repositório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2023-09-27T11:58:27Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false
dc.title.pt_BR.fl_str_mv Liberação endoscópica do túnel cubital na neurite hansênica do nervo ulnar
dc.title.en.pt_BR.fl_str_mv Endoscopic release of the cubital tunnel in leprosy neuritis of the ulnar nerve.
title Liberação endoscópica do túnel cubital na neurite hansênica do nervo ulnar
spellingShingle Liberação endoscópica do túnel cubital na neurite hansênica do nervo ulnar
Sampaio, Antônio Carlos Delgado
Endoscopia
Neuropatias Ulnares
Hanseníase
Endoscopia
Neuropatias Ulnares
Hanseníase
title_short Liberação endoscópica do túnel cubital na neurite hansênica do nervo ulnar
title_full Liberação endoscópica do túnel cubital na neurite hansênica do nervo ulnar
title_fullStr Liberação endoscópica do túnel cubital na neurite hansênica do nervo ulnar
title_full_unstemmed Liberação endoscópica do túnel cubital na neurite hansênica do nervo ulnar
title_sort Liberação endoscópica do túnel cubital na neurite hansênica do nervo ulnar
author Sampaio, Antônio Carlos Delgado
author_facet Sampaio, Antônio Carlos Delgado
author_role author
dc.contributor.author.fl_str_mv Sampaio, Antônio Carlos Delgado
dc.contributor.advisor1.fl_str_mv Leite, José Alberto Dias
contributor_str_mv Leite, José Alberto Dias
dc.subject.por.fl_str_mv Endoscopia
Neuropatias Ulnares
Hanseníase
topic Endoscopia
Neuropatias Ulnares
Hanseníase
Endoscopia
Neuropatias Ulnares
Hanseníase
dc.subject.ptbr.pt_BR.fl_str_mv Endoscopia
Neuropatias Ulnares
Hanseníase
description Ulnar nerve compression at the elbow is commonly called cubital tunnel syndrome, being the second most common compressive neuropathy of the upper limb, statistically second only to carpal tunnel syndrome. To better characterize the role of endoscopic cubital tunnel release in leprosy neuritis and determine whether there is an improvement in pain, sensitivity and strength with the use of this minimally invasive technique. A total of 44 endoscopic procedures for ulnar nerve decompression at the elbow were performed in patients who were previously diagnosed with leprosy neuritis. The inclusion criteria were surgical indications for ulnar nerve release and clinical treatment failure for 4 weeks in patients with cubital tunnel syndrome who had their ulnar nerve function, whether motor or sensitive, deteriorated progressively despite their receiving prednisone 1mg/kg/day and physiotherapy. For endoscopic release, the CTS Relief Kit (Linvatec. Largo, FL, USA) and a standard 4mm 30° arthroscope were used. The study included 39 patients, 29 (74.4%) males and 10 (25.6%) females. The age of the patients ranged from 12 to 64 years (33 ± 14.97). Five patients underwent bilateral release. The release demonstrated a statistically significant improvement in pain (p = 0.002), in sensitivity (p < 0.001), and in strength (p < 0.001). The best results were obtained when ulnar release was performed less than 6 months after surgery indication. None of the procedures were converted from endoscopic to open. No major complications (infection, vascular injury, and nervous injury) were reported. One patient had ulnar nerve subluxation. The endoscopic release of the ulnar nerve at the elbow in leprosy neuritis entails true and safe benefits for the patient, such as improvement in pain, sensitivity and strength.
publishDate 2022
dc.date.issued.fl_str_mv 2022
dc.date.accessioned.fl_str_mv 2023-09-27T11:57:36Z
dc.date.available.fl_str_mv 2023-09-27T11:57:36Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
format doctoralThesis
status_str publishedVersion
dc.identifier.citation.fl_str_mv SAMPAIO, Antônio Carlos Delgado. Liberação endoscópica do túnel cubital na neurite hansênica do nervo ulnar. 2022. 53 f. Tese (Doutorado em Ciências Médico-Cirúrgicas) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2022. Disponível em: http://repositorio.ufc.br/handle/riufc/74486. Acesso em: 27 set. 2023.
dc.identifier.uri.fl_str_mv http://repositorio.ufc.br/handle/riufc/74486
identifier_str_mv SAMPAIO, Antônio Carlos Delgado. Liberação endoscópica do túnel cubital na neurite hansênica do nervo ulnar. 2022. 53 f. Tese (Doutorado em Ciências Médico-Cirúrgicas) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2022. Disponível em: http://repositorio.ufc.br/handle/riufc/74486. Acesso em: 27 set. 2023.
url http://repositorio.ufc.br/handle/riufc/74486
dc.language.iso.fl_str_mv por
language por
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.source.none.fl_str_mv reponame:Repositório Institucional da Universidade Federal do Ceará (UFC)
instname:Universidade Federal do Ceará (UFC)
instacron:UFC
instname_str Universidade Federal do Ceará (UFC)
instacron_str UFC
institution UFC
reponame_str Repositório Institucional da Universidade Federal do Ceará (UFC)
collection Repositório Institucional da Universidade Federal do Ceará (UFC)
bitstream.url.fl_str_mv http://repositorio.ufc.br/bitstream/riufc/74486/10/license.txt
http://repositorio.ufc.br/bitstream/riufc/74486/9/2022_tese_acdsampaio.pdf
bitstream.checksum.fl_str_mv 8a4605be74aa9ea9d79846c1fba20a33
16a2f4715c8d1f67db4beadddcba1add
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
repository.name.fl_str_mv Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)
repository.mail.fl_str_mv bu@ufc.br || repositorio@ufc.br
_version_ 1847793005950402560