Sequential Meridian Based Acupuncture Combined With Standard Rehabilitation After Surgery for Severe Cubital Tunnel Syndrome: A Randomized Controlled Trial.
Ding L, Zhang Q, Si Y, Zhou H, Chen Z, Qu Y et al. · Annals of plastic surgery · 2026
Objective: To evaluate the efficacy of sequential meridian-based acupuncture combined with standard rehabilitation in patients after surgery for severe cubital tunnel syndrome (CuTS).
Methods: In this prospective randomized controlled trial, 40 patients with severe CuTS who underwent ulnar nerve decompression with subfascial anterior transposition combined with supercharged end-to-side nerve transfers (the pronator quadratus branch and the abductor digiti minimi branch to the deep branch of the ulnar nerve) were randomly assigned to a sequential acupuncture group and a standard rehabilitation group (n=20). The standard rehabilitation group received neurotrophic medication and progressive rehabilitation training; the sequential acupuncture group additionally received staged meridian-based acupuncture (the Small Intestine Meridian and the Triple Energizer Meridian were primarily selected during postoperative months 0 to 3, supplemented by the Large Intestine Meridian thereafter, combining filiform-needle acupuncture and electroacupuncture). Motor nerve conduction velocity (MCV), sensory nerve conduction velocity (SCV), lateral pinch strength ratio, ring-finger grip strength ratio, 2-point discrimination (2PD), DASH score, EQ-5D-5L score, and VAS score were assessed preoperatively and at 1, 3, and 6 months postoperatively.
Results: Thirty-seven patients completed follow-up (18 in the sequential acupuncture group and 19 in the standard rehabilitation group; overall dropout rate 7.5%), with no acupuncture-related adverse events. Baseline characteristics were balanced between the 2 groups (P>0.05). Beginning at 3 months postoperatively, improvements in MCV, lateral pinch strength ratio, ring-finger grip strength ratio, DASH score, and EQ-5D-5L score were greater in the sequential acupuncture group than in the standard rehabilitation group (P 0.05).
Conclusion: Sequential meridian-based acupuncture combined with standard rehabilitation accelerates postoperative electrophysiological and intrinsic hand muscle recovery and improves upper-limb function and quality of life in patients with severe CuTS. The therapeutic advantage emerges during postoperative months 3 to 6, the critical window of nerve regeneration, with a favorable safety profile.