scholarly journals P.086 Endoscopic assisted ulnar nerve decompression: a technical note

2017 ◽  
Vol 44 (S2) ◽  
pp. S35-S35
Author(s):  
MB Alotaibi ◽  
B Yarascavitch ◽  
K Reddy
Keyword(s):  
Ulnar Nerve ◽  
Early Identification ◽  
Skin Incision ◽  
Cubital Tunnel Syndrome ◽  
Technical Note ◽  
Surgical Approaches ◽  
Nerve Decompression ◽  
Endoscopic View ◽  
Tunnel Syndrome

Background: Cubital tunnel syndrome is the second most frequent upper extremity entrapment neuropathy. Various surgical approaches have been described in the literature for Ulnar nerve decompression, ranging from open In-situ decompression to endoscopic Ulnar nerve release. In this technical note we describe a new endoscopic approach for Ulnar nerve decompression. Methods: Four cadavers, a total of eight fresh arms were dissected using our new endoscopic technique. The technique involves a 2.5cm skin incision placed 2.5cm distal to the medial epicondyle, and perpendicular to the long nerve axis. Early identification of motor branches was achieved using this skin incision. Under endoscopic view using 30 degree rigid scope Ulnar nerves were decompressed Results: Early identification of motor branches was achieved using distally placed skin incision in all eight arms. Conclusions: The safety of identifying Ulnar nerve motor branches in the early steps of the procedure, and the avoidance of scar formation over the elbow joint are the proposed advantages of this approach. More clinical studies needed to validate this outcome.

scholarly journals Predicting Revision Following In Situ Ulnar Nerve Decompression for Patients With Idiopathic Cubital Tunnel Syndrome

2016 ◽  
Vol 41 (3) ◽  
pp. 427-435 ◽  
Author(s):  
Michael P. Gaspar ◽  
Patrick M. Kane ◽  
Dechporn Putthiwara ◽  
Sidney M. Jacoby ◽  
A. Lee Osterman
Keyword(s):  
Ulnar Nerve ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Nerve Decompression ◽  
Tunnel Syndrome

scholarly journals Predictors of surgical outcomes after in situ ulnar nerve decompression for cubital tunnel syndrome

2018 ◽  
Vol Volume 14 ◽  
pp. 69-74 ◽  
Author(s):  
Lingde Kong ◽  
Jiangbo Bai ◽  
Kunlun Yu ◽  
Bing Zhang ◽  
Jichun Zhang ◽  
...  
Keyword(s):  
Ulnar Nerve ◽  
Surgical Outcomes ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Nerve Decompression ◽  
Tunnel Syndrome

scholarly journals Simple in situ decompression for idiopathic cubital tunnel syndrome using minimal skin incision

2010 ◽  
Vol 63 (9-10) ◽  
pp. 601-606 ◽  
Author(s):  
In-Ho Jeon ◽  
Ivan Micic ◽  
Byung-Woo Lee ◽  
Seong-Man Lee ◽  
Poong-Tak Kim ◽  
...  
Keyword(s):  
Postoperative Outcome ◽  
Skin Incision ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Invasive Technique ◽  
Conduction Delay ◽  
Surgical Trauma ◽  
Tunnel Syndrome ◽  
The Mean

Cubital tunnel syndrome is one of the most frequently occurring compression neuropathy in the upper limb next to carpal tunnel syndrome. Recent minimal invasive technique has prompted us to gain clinical experience with simple in situ decompression with minimal skin incision for idiopathic cubital tunnel syndrome. Sixty six consecutive patients with cubital tunnel syndrome were treated using minimal skin incision technique. The mean age of the patients was 49.7 (range: 15-77) years and average follow up period was 23.9 months (range: 12-60 months). The severity of ulnar neuropathy was classified according to the McGowan classification: there were 17 in grade I , 47 in grade II and 2 in grade III. A preoperative nerve conduction study was done by inching method, which revealed motor conduction delay around the medial epicondyle. All operations were carried out in a day surgery unit under local anesthetics. The postoperative outcome was evaluated by Messina classification. The mean duration of the operation was 12 minutes. The technique was highly satisfactorily esthetic for all. Over 80% of the patients were completely satisfied with the procedure taking into consideration their symptoms. Postoperative outcome measures and patient satisfactions (pain, return to normal activities and work, scar and pillar tenderness) were comparable with published series of anterior transposition. The overall satisfactory results were recorded 81% in the patients of McGowan stage I and II. There were 2 cases of hematoma as a postoperative complication. This procedure is comparably effective alternative which involves less surgical trauma, morbidity and rehabilitation time with good surgical outcomes especially in mild and moderate degrees. Minimal skin incision is a simple, safe and effective method to treat patients with idiopathic cubital tunnel syndrome.

scholarly journals Anconeus Epitrochlearis Muscle Associated With Cubital Tunnel Syndrome: A Case Series

Hand ◽  
2018 ◽  
Vol 14 (4) ◽  
pp. 477-482
Author(s):  
Nicholas Kim ◽  
Ryan Stehr ◽  
Hani S. Matloub ◽  
James R. Sanger
Keyword(s):  
Ulnar Nerve ◽  
Nerve Conduction ◽  
Case Series ◽  
Cubital Tunnel Syndrome ◽  
Nerve Conduction Studies ◽  
Cubital Tunnel ◽  
Persistent Symptoms ◽  
Compressive Neuropathy ◽  
Tunnel Syndrome

Background: Cubital tunnel syndrome is a common compressive neuropathy of the upper extremity. The anconeus epitrochlearis muscle is an unusual but occasional contributor. We review our experience with this anomalous muscle in elbows with cubital tunnel syndrome. Methods: We retrospectively reviewed charts of 13 patients noted to have an anconeus epitrochlearis muscle associated with cubital tunnel syndrome. Results: Ten patients had unilateral ulnar neuropathy supported by nerve conduction studies. Three had bilateral cubital tunnel syndrome symptoms with 1 of those having normal nerve conduction studies for both elbows. Eight elbows were treated with myotomy of the anconeus epitrochlearis muscle and submuscular transposition of the ulnar nerve. The other 8 elbows were treated with myotomy of the anconeus epitrochlearis muscle and in situ decompression of the ulnar nerve only. All but 1 patient had either clinical resolution or improvement of symptoms at follow-up ranging from 2 weeks to 1 year after surgery. The 1 patient who had persistent symptoms had received myotomy and in situ decompression of the ulnar nerve only. Conclusions: An anomalous anconeus epitrochlearis occasionally results in compression of the ulnar nerve but is usually an incidental finding. Its contribution to compression neuropathy can be tested intraoperatively by passively ranging the elbow while observing the change in vector and tension of its muscle fibers over the ulnar nerve. Regardless of findings, we recommend myotomy of the muscle and in situ decompression of the ulnar nerve. Submuscular transposition of the ulnar nerve may be necessary if there is subluxation.

Minimally Invasive Ulnar Nerve Decompression for Cubital Tunnel Syndrome

2009 ◽  
Vol 5 (1) ◽  
pp. 16 ◽  
Author(s):  
Yong-Jun Cho ◽  
Sung-Min Cho ◽  
Seung-Hoon Sheen ◽  
Dong-Hwa Heo ◽  
Jun-Hyung Cho ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Ulnar Nerve ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Nerve Decompression ◽  
Tunnel Syndrome

Open vs Retractor-Endoscopic In Situ Decompression of the Ulnar Nerve in Cubital Tunnel Syndrome

Neurosurgery ◽  
2012 ◽  
Vol 72 (4) ◽  
pp. 605-616 ◽  
Author(s):  
Stephan Dützmann ◽  
K. Daniel Martin ◽  
Stephan Sobottka ◽  
Gerhard Marquardt ◽  
Gabriele Schackert ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Ulnar Nerve ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Matched Pairs ◽  
Short Term ◽  
Tunnel Syndrome ◽  
Endoscopic In Situ Decompression

Abstract BACKGROUND: Both open ulnar nerve decompression and retractor-endoscopic ulnar nerve decompression have been shown to yield good results. However, a comparative evaluation of the techniques is lacking. OBJECTIVE: To compare the results of open and endoscopic surgery in cubital tunnel syndrome. METHODS: One hundred fourteen patients undergoing open (n = 59) or endoscopic (n = 55) decompression of the ulnar nerve for cubital tunnel syndrome were retrospectively compared. The long- and short-term outcomes were compared with respect to the time until return to full activity and the duration of postoperative pain. Additionally, matched pairs between the 2 groups were chosen for analysis (n = 34). RESULTS: Long-term results in the open vs endoscopic groups were as follows: excellent results, 54.2% vs 56.4%; good results, 23.8% vs 32.7%; fair results, 20.3% vs 9.1%; and poor results, 1.7% vs 1.8%, respectively. For the matched pairs, the results had similar significance levels (P = .84). The times until return to full activity in the open vs the endoscopic groups were as follows: 2 to 7 days, 18.6% vs 76.4%; 7 to 14 days, 55.9% vs 10.9%; and > 14 days, 25.4% vs 12.7% (P < .001 between nonmatched and matched pairs). The durations of postoperative pain in the open vs the endoscopic groups were as follows: 1 to 3 days, 45.8% vs 67.3%; 3 to 10 days, 42.5% vs 25.4%; and > 10 days, 11.7% vs 7.3% (P =.04 for nonmatched and P = .05 for matched pairs). CONCLUSION: There are no significant differences in long-term outcomes after open and retractor-endoscopic in situ decompression of the ulnar nerve in cubital tunnel syndrome. The short-term results are significantly better in endoscopic surgery.

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