Simple Decompression with Small Skin Incision for Cubital Tunnel Syndrome

2002 ◽  
Vol 27 (6) ◽  
pp. 559-562 ◽  
Author(s):  
Y. TANIGUCHI ◽  
M. TAKAMI ◽  
T. TAMAKI ◽  
M. YOSHIDA
Keyword(s):  
Clinical Results ◽  
Skin Incision ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Endoscopic Assistance ◽  
Tunnel Syndrome ◽  
Grade Ii ◽  
The Mean ◽  
Simple Decompression

Eighteen elbows in 17patients with cubital tunnel syndrome were treated by simple decompression using only a 1.5–2.5 cm skin incision with no endoscopic assistance. According to McGowan’s criteria, three elbows were classified preoperatively as grade I, six as grade II and nine as grade III. The mean follow-up period was 14 months (range 3–25). Clinical results were evaluated as excellent for four elbows, good for ten and fair for four. Improvement of symptoms occurred in all patients and dislocation of the ulnar nerve was not observed. Simple decompression through a small skin incision can be recommended for the treatment of cubital tunnel syndrome, if the indication is appropriate.

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.

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.

Comparison of Simple Decompression and Anterior Subcutaneous Transposition of the Ulnar Nerve for the Treatment of Cubital Tunnel Syndrome

2018 ◽  
Vol 20 (6) ◽  
pp. 451-460 ◽  
Author(s):  
Taskin Altay ◽  
Kamil Yamak ◽  
Şemmi Koyuncu ◽  
Cemil Kayali ◽  
Serkan Sözkesen
Keyword(s):  
Ulnar Nerve ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Nerve Paralysis ◽  
Tunnel Syndrome ◽  
The Mean ◽  
Group 2 ◽  
Subcutaneous Transposition ◽  
Simple Decompression ◽  
Group 1

Background. In this study, we aim to evaluate clinical and functional results in patients with cubital tunnel syndrome who were treated with subcutaneous anterior transposition vs simple decompression of the ulnar nerve. Material and methods. Fifty-five patients were separated into two groups according to surgical technique. Group 1 comprised 35 patients (23 males, 12 females; mean age, 42.1 years; range, 28–56 years) who underwent anterior subcutaneous transposition of the ulnar nerve, whereas Group 2 included 20 patients (11 males, 9 females; mean age, 47.4 years; range, 25–59 years) who underwent simple decompression of the ulnar nerve. Results. The mean modified Bishop scores were 7.26 and 7.85 in Group 1 and Group 2, respectively (P< .05). The mean Q-DASH scores were 16.94 in Group 1 and 15.80 in Group 2 (P> .05). Postoperatively, paraesthesia regressed in 17 (85.7%) and 30 (85%) patients in Group 1 and Group 2, respectively (P> .05). Both groups demonstrated improvement in ulnar nerve function in comparison with the preoperative period, and ulnar nerve paralysis was not seen in any of our patients. A postsurgical incision scar developed in six (17.1%) and three patients (15%) in Group 1 and Group 2, respectively. Conclusion. Both simple decompression and anterior subcutaneous transposition of the ulnar nerve are effective and safe for the treatment of cubital tunnel syndrome, so we would favour simple decompression as it is a less extensive procedure.

Simple Decompression or Subcutaneous Anterior Transposition of the Ulnar Nerve for Cubital Tunnel Syndrome

2005 ◽  
Vol 30 (5) ◽  
pp. 521-524 ◽  
Author(s):  
A. NABHAN ◽  
F. AHLHELM ◽  
J. KELM ◽  
W. REITH ◽  
K. SCHWERDTFEGER ◽  
...  
Keyword(s):  
Motor Nerve ◽  
Operative Procedure ◽  
Cubital Tunnel Syndrome ◽  
Neurological Deficits ◽  
Cubital Tunnel ◽  
Nerve Decompression ◽  
Anterior Transposition ◽  
Tunnel Syndrome ◽  
Simple Decompression

The purpose of this prospective randomised study was to evaluate which operative technique for treatment of cubital tunnel syndrome is preferable: subcutaneous anterior transposition or nerve decompression without transposition. This study included 66 patients suffering from pain and/or neurological deficits with clinically and electromyographically proven cubital tunnel syndrome. Thirty-two patients underwent nerve decompression without transposition and 34 underwent subcutaneous transposition of the nerve. Follow-up examinations evaluating pain, motor and sensory deficits as well as motor nerve conduction velocities, were performed 3 and 9 months postoperatively. There were no significant differences between the outcomes of the two groups at either postoperative follow-up examination. We recommend simple decompression of the nerve in cases without deformity of the elbow, as this is the less invasive operative procedure.

A systematic review of medial epicondylectomy as a surgical treatment for cubital tunnel syndrome

2017 ◽  
Vol 42 (9) ◽  
pp. 941-945 ◽  
Author(s):  
Eva E. O’Grady ◽  
Qureish Vanat ◽  
Dominic M. Power ◽  
Simon Tan
Keyword(s):  
Systematic Review ◽  
Methodological Quality ◽  
Surgical Techniques ◽  
Case Series ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Level Of Evidence ◽  
Tunnel Syndrome ◽  
The Mean ◽  
Simple Decompression

The aim of this study was to review the literature of decompression of the cubital tunnel with medial epicondylectomy and to assess outcomes and complications. Twenty-one case series reported on 886 medial epicondylectomies. The mean percentage of patients obtaining improvement of one or more McGowan grade was 79%. The mean percentage obtaining a good/excellent Wilson Krout grade of outcome was 83%. Of six comparative studies, two showed no significant differences in outcomes between medial epicondylectomy and transposition procedures, and three reported better outcomes with medial epicondylectomy. One reported similar outcomes with medial epicondylectomy and simple decompression. The existing literature on medial epicondylectomy is of limited methodological quality and does not allow for firm conclusions to be drawn regarding its efficacy compared with other surgical techniques. Further studies should aim for high methodological quality, randomized comparison with simple decompression or anterior transposition and should utilize standardized outcome measures. Level of evidence: II

Treatment of Cubital Tunnel Syndrome by Frontal Partial Medial Epicondylectomy. A Retrospective Series of 55 Cases

2004 ◽  
Vol 29 (6) ◽  
pp. 563-567 ◽  
Author(s):  
M. POPA ◽  
TH. DUBERT
Keyword(s):  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Osteotomy Site ◽  
Extension Deficit ◽  
Satisfaction Rate ◽  
Nerve Recovery ◽  
Tunnel Syndrome ◽  
Grade Ii ◽  
Grade Iii

The outcomes of 55 cases of cubital tunnel syndrome treated by a partial frontal epicondylectomy are presented at a mean follow-up of 38 months follow-up. According to McGowan classification, 25 cases were grade I (45%), 12 grade II (22%) and 18 grade III (33%). The results (Wilson and Krout classification) were excellent or good in 41 patients (75%), fair in nine patients and unchanged in five, without any worsening or recurrence. Total relief was reported in 80% of grade I, 75% of grade II and 66% of grade III patients. Seven painful scars and one persistent 15° elbow extension deficit were the only complications. The satisfaction rate was 93%. This technique preserves bony protection, the blood supply and gliding tissues for the nerve and nerve recovery were comparable to other surgical procedures. Residual pain at the osteotomy site was not a serious problem.

Simultaneous Compression of the Median and Ulnar Nerve at the Elbow: A Retrospective Study

2018 ◽  
Vol 23 (02) ◽  
pp. 198-204 ◽  
Author(s):  
Dimitrios Skouteris ◽  
Sofia Thoma ◽  
Georgios Andritsos ◽  
Nikolaos Tasios ◽  
Praxitelis Praxitelous ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Ulnar Nerve ◽  
Correct Diagnosis ◽  
Sudden Onset ◽  
Cubital Tunnel Syndrome ◽  
Surgical Decompression ◽  
Cubital Tunnel ◽  
Tunnel Syndrome ◽  
Proximal Forearm

Background: Simultaneous compression of the median and ulnar nerve at the elbow region has not been sufficiently highlighted in the literature. The purposes of the present study are to report our experience regarding this entity, to elucidate the clinical features, and to describe the operative technique and findings as well as the results of simultaneous decompression performed through the same medial incision. Methods: We performed a retrospective study of thirteen elbows in thirteen patients -nine men and four women- with simultaneous compression of the median and ulnar nerve at the elbow region between 2000 and 2011. All were manual workers. Diagnosis was largely based on symptoms, patterns of paresthesia, and specific tests. Surgical decompression of both nerves at the same time was performed through a single anteromedial incision creating large flaps. Results: Patients were followed for a mean of thirty-eight months (range seven to ninety six). Resting pain in the proximal forearm as well as sudden onset of numbness in the ring and little fingers were reported by all patients. Nerve conduction studies were positive only for cubital tunnel syndrome. In all patients symptoms subsided following surgical decompression. At the time of final follow up there is no evidence of recurrence. Conclusions: Proximal median nerve compression can be seen in association with cubital tunnel syndrome. Careful evaluation of the reported symptoms as well as thorough clinical examination are the keystone of the correct diagnosis. Also, on the basis of this study, we believe that concurrent decompression can be performed through a single medial incision, though extensive dissection may be required.

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