http___www.toncic.net_kirurski-zahvati_sindrom-kubitalnog-kanala__1.xml
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Cubital tunnel syndrome is manifested through tingles and loss of sensation in half of the ring finger and the little finger, pain in the hand and forearm, weakening of the hand muscles. It develops because of the pressure on the ulnar nerve in the elbow area. With untreated patients it slowly turns into nerve deterioration and permanent loss of sensation and hand muscles. The diagnosis is formed based on the described symptoms and can be confirmed with an EMG examination. TREATMENT Cubital tunnel syndrome can be treated in a few ways, including change of activity, immobilization, anti-inflammatory medication, steroid injections in the area where the nerve is being pressed on and surgical treatment. SURGICAL TREATMENT In our clinic this procedure is performed by an experienced surgical team, and the operation itself consists of cutting the structure in the elbow area which can be the source of the pressure on the nerve. The operation is carried through under general anesthesia or under block type anesthetics (the patient is awake the entire time of the operation and the hand is numb) and is painless for the patient. After releasing the nerve, it is left in the same place if it was a gentle pressure, and if it is a stronger pressure, the nerve is transferred in the front of the elbow, under the skin or inside the muscle. After the operation a drain is placed inside the wound and left there for two to three days. RECOVERY The final result of the operation depends on the course of the operation, the experience of the surgeon and his team, but to a significant extent, it also depends on conscientious and detailed postoperative monitoring and control. To be sure of the success of the operation and wellbeing of the patient, we insist on regular check ups and everyday contact with the patient. We monitor our patient’s recovery completely, which is crucial for our patient’s health and the result of the operation. The patient is usually discharged from the clinic the same day and is advised to rest with their arm put in a elevated position. The drain is usually removed the second or third day after the surgery and the stitches are removed two weeks following the surgery. Patients are usually capable to drive a week after the operation, and returning to their jobs greatly depends on the type of the job they do. PROGNOSIS Patients who didn’t permanently lose sensation and their hand muscles haven’t completely weakened before the operation have a better prognosis. These patients can expect a full recovery of their nerve function. Patients who have lost sensation and their hand muscles have weakened before the operation may experience the same symptoms permanently even after the surgery.
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Sindrom kubitalnog kanala se manifestira trncima i gubitkom osjeta u polovici prstenjaka i malom prstu, slabljenjem mišića šake, bolovima u šaci i podlaktici, a nastaje zbog pritiska na ulnarni živac u području lakta. Kod neliječenih bolesnika postupno dolazi do propadanja živca, trajnog gubitka osjeta i nestajanja mišića šake. Dijagnoza se postavlja na temelju opisanih simptoma, a može se potvrditi EMNG pretragom. LIJEČENJE Sindrom kubitalnog kanala se može liječiti na više načina koji uključuju promjenu aktivnosti, imobilizaciju, protuupalne lijekove, injekciju steroida u područje pritiska na živac te kirurško liječenje. KIRURŠKO LIJEČENJE U okviru naše poliklinike ovaj zahvat izvodi iskusan kirurški tim, a sama operacija se sastoji u presjecanju struktura u području lakta, koje mogu biti uzrok pritiska na živac. Operacija se izvodi u općoj anesteziji ili u blok anesteziji (bolesnik je budan za vrijeme operacije, a umrtvljuje se cijela ruka) te je za pacijenta bezbolna. Nakon oslobadjanja živca, on se u slučaju blagog pritiska ostavlja na istom mjestu, dok se kod jačeg pritiska živac premješta na prednju stranu lakta, ispod kože ili unutar mišića. Nakon operacije u ranu se postavlja dren koji se ostavlja 2 do 3 dana. OPORAVAK Konačni rezultat operacije, osim o tijeku same operacije, iskustvu kirurga i njegovog tima, ovisi u velikoj mjeri i o savjesnom i temeljitom postoperativnom praćenju i njezi. Iz navedenih razloga u okviru naše poliklinike inzistiramo na redovitim kontrolama i svakodnevnom kontaktu s pacijentom, kako bi se period oporavka što uspješnije i bez komplikacija priveo kraju. Bolesnik uobičajeno ide kući isti dan nakon operacije uz preporuku mirovanja s rukom na povišenom položaju. Dren se obično uklanja drugi ili treći postoperacijski dan, a konci se skidaju nakon dva tjedna. Tjedan dana nakon operacije bolesnici su obično sposobni voziti automobil, a povratak na posao uvelike ovisi o vrsti posla. PROGNOZA Bolju prognozu za oporavak imaju bolesnici kod kojih prije operacije nije došlo do trajnog gubitka osjeta te slabljenja mišića šake. Kod ovih se bolesnika može očekivati potpuni oporavak funkcije živca. Kod bolesnika s trajnim gubitkom osjeta i slabljenjem mišića šake ovi simptomi mogu biti trajno prisutni unatoč operaciji.