Effect of Ultrasound-Guided Nerve Hydrodissection Combined with Rehabilitation on Patients with Cubital Tunnel Syndrome with Long Course

<bold>Objective</bold>A patient with cubital tunnel syndrome with a course of more than 35 years was treated by nerve hydrodissection combined with rehabilitation，and the new clinical diagnosis and treatment ideas and technical means of cubital tunnel syndrome with a long course of disease were discussed. .<bold>Methods</bold>The rehabilitation treatment plan for this patient includes：1） Treatment of the right elbow using laser therapy，infrared therapy，and medium-frequency pulse electrotherapy，once daily for 20 minutes，over a period of 3 weeks; 2） Application of Maitland Grade III and IV joint mobilization techniques to improve joint range of motion，once daily for 10 minutes，for 3 weeks; 3） Gentle stretching of the ulnar nerve through specific movements （such as shoulder abduction，elbow extension，and wrist extension），once daily for 10 minutes，over a period of 3 weeks; 4） Nerve hydrodissection under ultrasound guidance，once weekly，for a total of 3 treatments，over a span of 3 weeks. The assessment of changes in the patient's condition before and after treatment will be conducted using muscle strength tests，active range of motion （AROM），the upper extremity functional scale （ARAT），and the Numeric Rating Scale （NRS） for pain.<bold>Results</bold>The abductor muscle strength of the right little finger was grade 4 before treatment，and grade 5- after treatment. There was no significant difference in the deep flexion muscle strength of the ring little finger，the index finger，the palm-to-palm muscle strength of the little finger and the adduction muscle strength of the thumb before and after treatment. . The active range of motion （AROM） for extending the right elbow was 25° before treatment and decreased to 20° after treatment，with no significant change in flexion. The numeric rating scale （NRS） for pain in the skin of the ulnar side of the right forearm and the ring and little fingers was 8 before treatment，and reduced to 4 after treatment，indicating an improvement from severe pain to moderate pain. The upper limb action assessment scale （ARAT） score was 46 points before treatment，and increased to 50 points after treatment.<bold>Conclusion</bold>For chronic elbow canal syndrome with an extended course，surgical treatment is generally preferred. However，this case was treated with ultrasound-guided nerve hydrodissection，achieving favorable clinical results. This provides a new clinical approach and technical means for the non-surgical treatment of chronic elbow canal syndrome.