The Anatomy, Presentation and Management Options of Cubital Tunnel Syndrome

2020 ◽  
Vol 25 (04) ◽  
pp. 393-401
Author(s):  
Arjuna Thakker ◽  
Vinay Kumar Gupta ◽  
Keshav Kumar Gupta
Keyword(s):  
Surgical Techniques ◽  
Cubital Tunnel Syndrome ◽  
Nerve Damage ◽  
Cubital Tunnel ◽  
Loss Of Function ◽  
Management Options ◽  
Nerve Compression Syndrome ◽  
Clinical Presentations ◽  
Tunnel Syndrome ◽  
Simple Decompression

Cubital tunnel syndrome is the second most common nerve compression syndrome seen in the upper limb. Paresthesia and weakness are the two most common presentations in the hand. If left untreated, compression can lead to irreversible nerve damage, resulting in a loss of function of the forearm and hand. Therefore, recognizing the various clinical presentations of cubital tunnel syndrome can lead to early detection and prevention of nerve damage. Conservative management is usually tried first and involves supporting the elbow using a splint. If this fails and symptoms do not improve, surgical management is indicated. There are 3 main surgical techniques used to relieve compression of the nerve. These are simple decompression, anterior transposition and medial epicondylectomy. Studies comparing the techniques have demonstrated particular advantages to using one or another. However, the overall technique of choice is based on both the clinical scenario and the surgeon’s digression. Following primary cubital tunnel surgery, recurrent symptoms can often occur due to a variety of pathological and non-pathological causes and revision surgery is usually warranted. This article provides a complete review of cubital tunnel syndrome.

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

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.

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.

RISK FACTORS FOR DISLOCATION OF THE ULNAR NERVE AFTER SIMPLE DECOMPRESSION FOR CUBITAL TUNNEL SYNDROME

Hand Surgery ◽  
2014 ◽  
Vol 19 (01) ◽  
pp. 13-18 ◽  
Author(s):  
K. Murata ◽  
S. Omokawa ◽  
T. Shimizu ◽  
Y. Nakanishi ◽  
K. Kawamura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ulnar Nerve ◽  
High Probability ◽  
Multiple Logistic Regression Analysis ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Anterior Dislocation ◽  
Multiple Logistic Regression ◽  
Tunnel Syndrome ◽  
Simple Decompression

Anterior dislocation of the ulnar nerve is occasionally encountered after simple decompression of the nerve for treatment of cubital tunnel syndrome. The purpose of this study was to determine whether the incidence of dislocation of the nerve following simple decompression of the nerve is correlated with the patient's preoperative characteristics and/or elbow morphology. We studied 51 patients with cubital tunnel syndrome who underwent surgery at our institution. Intraoperatively, we simulated dislocation of the nerve after simple decompression by flexing the elbow after releasing the nerve in each patient. Univariate and multiple logistic regression analysis showed that young age and a small ulnar nerve groove angle are positively correlated with dislocation of the nerve. Our results suggest that patients who are young and/or have a sharply angled ulnar nerve groove identified radiographically have a high probability of experiencing anterior dislocation of the ulnar nerve after simple decompression.

The cubital tunnel syndrome: Treatment with simple decompression

1980 ◽  
Vol 7 (6) ◽  
pp. 567-569 ◽  
Author(s):  
Robert G. Miller ◽  
Errett E. Hummel
Keyword(s):  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Tunnel Syndrome ◽  
Simple Decompression

scholarly journals Cubital tunnel syndrome

2021 ◽  
Vol 6 (9) ◽  
pp. 743-750
Author(s):  
Abdus S. Burahee ◽  
Andrew D. Sanders ◽  
Colin Shirley ◽  
Dominic M. Power
Keyword(s):  
Ulnar Nerve ◽  
Motor Nerve ◽  
Nerve Transfer ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Common Procedure ◽  
Tunnel Syndrome ◽  
Distal Nerve ◽  
Denervated Muscles ◽  
Simple Decompression

Cubital tunnel syndrome (CuTS) is the second most common compression neuropathy of the upper limb, presenting with disturbance of ulnar nerve sensory and motor function. The ulnar nerve may be dynamically compressed during movement, statically compressed due to reduction in tunnel volume or compliance, and tension forces may cause ischaemia or render the nerve susceptible to subluxation, further causing local swelling, compression inflammation and fibrosis. Superiority of one surgical technique for the management of CuTS has not been demonstrated. Different techniques are selected for different clinical situations with simple decompression being the most common procedure due to its efficacy and low complication rate. Adjunctive distal nerve transfer for denervated muscles using an expendable motor nerve to restore the axon population in the distal nerve is in its infancy but may provide a solution for severe intrinsic weakness or paralysis. Cite this article: EFORT Open Rev 2021;6:743-750. DOI: 10.1302/2058-5241.6.200129

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