scholarly journals Ulnar nerve morphology on magnetic resonance imaging predicts nerve recovery after surgery for cubital tunnel syndrome

2021 ◽  
Author(s):  
Jong Seop Kim ◽  
Gajendra Mani Shah ◽  
Young Joo Chae ◽  
Ji Sup Hwang ◽  
Joong Mo Ahn ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Ulnar Nerve ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Resonance Imaging ◽  
Nerve Recovery ◽  
Tunnel Syndrome

Recurrent Cubital Tunnel Syndrome Caused by Ganglion: A Report of Nine Cases

2018 ◽  
Vol 23 (02) ◽  
pp. 210-216 ◽  
Author(s):  
Masatoshi Komatsu ◽  
Shigeharu Uchiyama ◽  
Takumi Kimura ◽  
Naoki Suenaga ◽  
Masanori Hayashi ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Ulnar Nerve ◽  
Cubital Tunnel Syndrome ◽  
Resonance Imaging ◽  
Initial Surgery ◽  
Second Surgery ◽  
Chief Complaints ◽  
Elbow Osteoarthritis ◽  
Tunnel Syndrome

Background: Cubital tunnel syndrome (CuTS) is generally treated successfully by surgery and recurrent cases are rare. This study retrospectively investigated the clinical characteristics of recurrent CuTS caused by ganglion. Methods: We evaluated nine patients who were surgically treated for recurrent CuTS caused by ganglion. Age distribution at recurrence ranged from 43 to 79 years. The initial surgery for CuTS had been performed using various methods. The asymptomatic period from initial surgery to recurrence ranged from 22 to 252 months. Clinical, diagnostic imaging, and operative findings during the second surgery were analyzed. All patients were treated by anterior subcutaneous ulnar nerve transposition with ganglion resection and later examined directly within a mean of 71 months after the second surgery. Results: The interval from recurrence to consultation was shorter than two months for eight cases. Chief complaints included numbness with or without pain in the ring and little fingers in all patients and resting pain in the medial elbow in five patients. Elbow osteoarthritis was present in all cases. Although four of 10 ganglia were palpable, ultrasonography and magnetic resonance imaging could identify all ganglia preoperatively. The ulnar nerve typically had become entrapped by the ganglion posteriorly and by fascia, scar tissue, and/or muscle anteriorly. Chief complaints and ulnar nerve function were improved in all patients following revision surgery. Conclusions: The acute onset of numbness with or without intolerable pain in the ring and little fingers after a long-term remission period following initial surgery for CuTS in patients with elbow osteoarthritis appears to be the characteristic clinical profile of recurrent CuTS caused by ganglion. As ganglia are often not palpable, ultrasonography and magnetic resonance imaging are recommended for accurate diagnosis.

DIFFUSION-WEIGHTED MAGNETIC RESONANCE IMAGING OF THE ULNAR NERVE IN CUBITAL TUNNEL SYNDROME

Hand Surgery ◽  
2010 ◽  
Vol 15 (01) ◽  
pp. 11-15 ◽  
Author(s):  
K. Iba ◽  
T. Wada ◽  
M. Tamakawa ◽  
M. Aoki ◽  
T. Yamashita
Keyword(s):  
Magnetic Resonance ◽  
Ulnar Nerve ◽  
Signal Intensity ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
High Signal ◽  
Diffusion Weighted Mri ◽  
Diffusion Weighted Images ◽  
Diffusion Weighted ◽  
Tunnel Syndrome

Diffusion-weighted images based on magnetic resonance reveal the microstructure of tissues by monitoring the random movement of water molecules. In this study, we investigated whether this new technique could visualize pathologic lesions on ulnar nerve in cubital tunnel. Six elbows in six healthy males without any symptoms and eleven elbows in ten patients with cubital tunnel syndrome underwent on diffusion-weighted MRI. No signal from the ulnar nerve was detected in normal subjects. Diffusion-weighted MRI revealed positive signals from the ulnar nerve in all of the eleven elbows with cubital tunnel syndrome. In contrast, conventional T2W-MRI revealed high signal intensity in eight elbows and low signal intensity in three elbows. Three elbows with low signal MRI showed normal nerve conduction velocity of the ulnar nerve. Diffusion-weighted MRI appears to be an attractive technique for diagnosis of cubital tunnel syndrome in its early stages which show normal electrophysiological and conventional MRI studies.

scholarly journals Ulnar Nerve Morphology in Magnetic Resonance Imaging Predicts Nerve Recovery After Surgery for Cubital Tunnel Syndrome

2020 ◽  
Author(s):  
Jong Seop Kim ◽  
Young Ju Chae ◽  
Gajendra Mani Shah ◽  
Hyun Sik Gong
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ulnar Nerve ◽  
Signal Intensity ◽  
Cubital Tunnel Syndrome ◽  
Sectional Area ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Intensity Changes ◽  
Tunnel Syndrome ◽  
Poor Outcomes

Abstract Background: Magnetic resonance imaging (MRI) is helpful for the diagnosis of cubital tunnel syndrome (CuTS), but its prognostic value for surgical outcomes is unknown. We aimed to determine whether MRI parameters correlated with outcomes after surgery for CuTS. Methods: We reviewed 40 patients who had electrodiagnostic tests and MRIs for CuTS preoperatively and had 6-month evaluations postoperatively. The MRI parameters were ulnar nerve cross-sectional area (UNCSA) measured at 6 different levels around the medial epicondyle (ME), signal intensity changes of innervated muscles of the ulnar nerve, and the presence of ganglion around the ulnar nerve. Other factors assessed were age, symptom duration, symptom severity, presence of diabetes mellitus, and electrodiagnostic parameters including motor nerve conduction velocity (mNCV). We analyzed the factors associated with fair or poor outcomes graded by Wilson-Krout classification. Results: The UNCSA was the largest at ME level and smallest at 3cm distal to ME level. Increased ulnar nerve signal intensity changes were found in 34 subjects and increased forearm muscle signal intensity changes were found in two. Ten patients were found to have ganglia. Twelve patients (30%) had excellent results, 19 (48%) had good, 8 (20%) had fair, and 1 (4%) had a poor result. In univariate analysis, fair or poor outcomes were associated with increased UNCSA 1 cm proximal and 1 cm distal from the ME, the presence of ganglion, and decreased mNCV. In multivariate analysis, fair or poor outcomes were associated with either increased UNCSA 1 cm distal from the ME (OR 11.15; p = 0.019), or increased UNCSA 1 cm proximal from the ME (OR 16.01; p = 0.038) and decreased mNCV (OR 0.92; p = 0.044).Conclusions: This study demonstrated that increased ulnar nerve cross-sectional area on MRI correlated with suboptimal improvement after surgery for CuTS at 6 months follow up. MRI examination for morphologic changes of the ulnar nerve can be helpful for patient consultation on the prognosis of surgery for CuTS.

scholarly journals Management of cubital tunnel syndrome by anterior trans-muscular transposition of the ulnar nerve

2019 ◽  
Vol 34 (1) ◽  
Author(s):  
Ahmed Shawky Ammar ◽  
Mohamed Ahmed El Tabl ◽  
Dalia Salah Saif
Keyword(s):  
Clinical Outcome ◽  
Ulnar Nerve ◽  
Visual Analog Scale ◽  
Electrophysiological Study ◽  
Cubital Tunnel Syndrome ◽  
Nerve Entrapment ◽  
Cubital Tunnel ◽  
Analog Scale ◽  
Tunnel Syndrome ◽  
Dash Questionnaire

Abstract Background Various surgical options are used for the treatment of ulnar nerve entrapment at the elbow. In this study, anterior trans-muscular transposition of the ulnar nerve was used for the treatment of cubital tunnel syndrome. Objectives To evaluate the surgical results of anterior trans-muscular transposition technique for the treatment of cubital tunnel syndrome with particular emphasis on clinical outcome. Methods Forty patients with cubital tunnel syndrome were operated using anterior trans-muscular transposition technique. Patients were classified into post-operative clinical outcome grades according to the Wilson & Krout criteria, and they were followed up by visual analog scale (VAS), the Disability of Arm Shoulder and Hand (DASH) questionnaire, electrophysiological study, and post-operative clinical evaluation. Results Forty patients with cubital tunnel syndrome who underwent anterior trans-muscular transposition of the ulnar nerve show a significant clinical improvement at 24 months post-surgery regarding visual analog scale (VAS), the Disability of Arm Shoulder and Hand (DASH) questionnaire, electrophysiological study, and the Wilson & Krout grading as 87.5% of the patients recorded excellent and good outcome. Conclusion Anterior transmuscular transposition of the ulnar nerve is a safe and effective treatment for ulnar nerve entrapment at the elbow.

ASSOCIATIONS BETWEEN ULNAR NERVE STRAIN AND ACCOMPANYING CONDITIONS IN PATIENTS WITH CUBITAL TUNNEL SYNDROME

Hand Surgery ◽  
2014 ◽  
Vol 19 (03) ◽  
pp. 329-333 ◽  
Author(s):  
Kensuke Ochi ◽  
Yukio Horiuchi ◽  
Toshiyasu Nakamura ◽  
Kazuki Sato ◽  
Kozo Morita ◽  
...  
Keyword(s):  
Disease Severity ◽  
Ulnar Nerve ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Tunnel Syndrome ◽  
The Mean ◽  
Simple Decompression

Pathophysiology of cubital tunnel syndrome (CubTS) is still controversial. Ulnar nerve strain at the elbow was measured intraoperatively in 13 patients with CubTS before simple decompression. The patients were divided into three groups according to their accompanying conditions: compression/adhesion, idiopathic, and relaxation groups. The mean ulnar nerve strain was 43.5 ± 30.0%, 25.5 ± 14.8%, and 9.0 ± 5.0% in the compression/adhesion, idiopathic, and relaxation groups respectively. The mean ulnar nerve strains in patients with McGowan's classification grades I, II, and III were 18.0 ± 4.2%, 27.1 ± 22.7%, and 33.7 ± 24.7%, respectively. The Jonckheere-Terpstra test showed that there were significant reductions in the ulnar nerve strain among the first three groups, but not in the three groups according to McGowan's classification. Our results suggest that the pathophysiology, not disease severity, of CubTS may be explained at least in part by the presence of ulnar nerve strain.

A CASE REPORT OF ACUTE CUBITAL TUNNEL SYNDROME CAUSED BY VENOUS THROMBOSIS

Hand Surgery ◽  
2015 ◽  
Vol 20 (01) ◽  
pp. 137-139 ◽  
Author(s):  
Yoshihiro Abe ◽  
Masahiko Saito
Keyword(s):  
Case Report ◽  
Venous Thrombosis ◽  
Ulnar Nerve ◽  
Cubital Tunnel Syndrome ◽  
Nerve Compression ◽  
Ulnar Neuropathy ◽  
Cubital Tunnel ◽  
Ulnar Nerve Compression ◽  
Compression Neuropathy ◽  
Tunnel Syndrome

Compression neuropathy of the ulnar nerve at the elbow is well-recognised as cubital tunnel syndrome (CuTS). Many causes of ulnar neuropathy at the elbow have been identified. A previously unreported finding of ulnar nerve compression in the cubital tunnel caused by a thrombosed proximal ulnar recurrent artery vena comitans is described.

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