Long-term Reoperation Rate for Cubital Tunnel Syndrome: Subcutaneous Transposition Versus In Situ Decompression

Hand ◽  
2019 ◽  
pp. 155894471987315
Author(s):  
Douglas T. Hutchinson ◽  
Ryan Sullivan ◽  
Micah K. Sinclair
Keyword(s):  
Ulnar Nerve ◽  
Reoperation Rate ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Multicenter Cohort Study ◽  
Tunnel Syndrome ◽  
Subcutaneous Transposition

Background: The purpose of this study was to compare the long-term revision rate of in situ ulnar nerve decompression with anterior subcutaneous transposition surgery for idiopathic cubital tunnel syndrome. Methods: This retrospective, multicenter, cohort study compared patients who underwent ulnar nerve surgery with a minimum 5 years of follow-up. The primary outcome studied was the need for revision cubital tunnel surgery. In total, there were 132 cases corresponding to 119 patients. The cohorts were matched for age and comorbidity. Results: The long-term reoperation rate for in situ decompression was 25% compared with 12% for anterior subcutaneous transposition. Seventy-eight percent of revisions of in situ decompression were performed within the first 3 years. Younger age and female sex were identified as independent predictors of need for revision. Conclusions: In the long-term follow-up, in situ decompression is seen to have a statistically significant higher reoperation rate compared with subcutaneous transposition.

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.

scholarly journals The utility of ultrasound examination in cubital tunnel syndrome caused by heterotopic ossification

2020 ◽  
Vol 1 (1) ◽  
pp. 117
Author(s):  
Jakub Jačisko ◽  
Karolína Sobotová ◽  
Kamal Mezian
Keyword(s):  
Heterotopic Ossification ◽  
Ulnar Nerve ◽  
Ultrasound Examination ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Entrapment Syndrome ◽  
Heterotopic Ossifications ◽  
Tunnel Syndrome

This case presents the utility of ultrasound examination in diagnostics, providing accurate therapy and follow-up of entrapment syndrome of the ulnar nerve, caused by heterotopic ossification. The heterotopic ossifications were in this case presumably linked to a long-term working with a vibration sander.

scholarly journals Endoscopic cubital tunnel decompression – Review of the literature

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902098208
Author(s):  
Margaret Woon Man Fok ◽  
Tyson Cobb ◽  
Gregory I Bain
Keyword(s):  
Ulnar Nerve ◽  
Randomized Study ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Short Term ◽  
Compressive Neuropathy ◽  
Endoscopic Guidance ◽  
Tunnel Syndrome ◽  
Subcutaneous Transposition

Cubital tunnel syndrome is the second most common compressive neuropathy of the upper limb. Endoscopic cubital tunnel decompression has gained popularity in recent years as this enables surgeons to achieve decompression of the ulnar nerve along its course using a small incision. This article describes the technical peals in performing endoscopic cubital tunnel decompression. In conditions which anterior transposition of the ulnar nerve is needed, subcutaneous transposition can be performed under endoscopic guidance. In addition, current literature is reviewed, and outcomes are presented. While short term results are encouraging, further prospective randomized study with longer follow-up is recommended.

Simple Endoscopic Decompression of Cubital Tunnel Syndrome With the Agee System

2010 ◽  
Vol 66 (suppl_2) ◽  
pp. ons325-ons332 ◽  
Author(s):  
Axel Thomas Stadie ◽  
Doerthe Keiner ◽  
Gerrit Fischer ◽  
Jens Conrad ◽  
Stefan Welschehold ◽  
...  
Keyword(s):  
Ulnar Nerve ◽  
Cubital Tunnel Syndrome ◽  
Nerve Entrapment ◽  
Endoscopic Technique ◽  
Cubital Tunnel ◽  
Long Term Follow Up ◽  
Tunnel Syndrome ◽  
Nerve Entrapment Syndrome

Abstract BACKGROUND Simple decompression in ulnar nerve compression syndromes offers options for endoscopic applications. OBJECTIVE The authors present their initial experience with the Agee device. PATIENTS AND METHODS The monoportal endoscopic technique (Agee system) was evaluated on 10 cadaveric arms. Subsequently, 32 arms of 29 patients were operated on between January 2006 and March 2009. All patients presented with typical clinical signs and neurophysiologic studies. Long-term follow-up examinations were obtained in 27 of 32 arms. RESULTS In the cadaver study, the ulnar nerve was always correctly identified. No nerve damage occurred, and sufficient decompression of the ulnar nerve was always achieved. In the clinical series, no intraoperative complications were observed. A change to open technique was not required, and no worsening of the cubital tunnel syndrome occurred. Two wound infections required surgical wound cleaning. Wound hematomas treated conservatively were found in 5 cases. On long-term follow-up, an improvement in the McGowan-Classification was achieved in 22 of 27 cases. One patient was operated on by open surgery after endoscopic surgery. CONCLUSION The endoscopic technique for ulnar nerve entrapment syndrome using an Agee device appears to be safe and efficient. The results are comparable to those achieved with simple open decompression. A randomized prospective study should be performed to further evaluate the value of new technique in ulnar nerve entrapment syndrome.

scholarly journals Incidence of Re-Operation and Subjective Outcome Following in Situ Decompression of the Ulnar Nerve at the Cubital Tunnel

2009 ◽  
Vol 34 (3) ◽  
pp. 379-383 ◽  
Author(s):  
C. A. GOLDFARB ◽  
M. M. SUTTER ◽  
E. J. MARTENS ◽  
P. R. MANSKE
Keyword(s):  
Ulnar Nerve ◽  
Failure Rate ◽  
Chart Review ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Persistent Symptoms ◽  
Additional Surgery ◽  
Tunnel Syndrome

The purpose of this investigation was to determine the failure rate of in situ decompression for cubital tunnel syndrome as determined by the need for additional surgery. We performed a comprehensive chart review of 56 adult patients who had undergone in situ decompression for cubital tunnel syndrome in 69 extremities with more than 1 year follow-up. The patients completed a comprehensive questionnaire concerning preoperative and postoperative pain, numbness, and weakness. After decompression, symptoms were improved substantially or resolved. Five limbs (7%) with persistent symptoms postoperatively were treated successfully with anterior submuscular transposition. These data suggest that in situ decompression of the ulnar nerve is a reliable treatment for cubital tunnel syndrome and has a low failure rate. The uncommon patient with continued symptoms after decompression can be treated effectively with transposition of the ulnar nerve.

scholarly journals Ulnar Nerve Neuropathy Secondary to “Snapping Triceps Syndrome”

2017 ◽  
Vol 3 ◽  
pp. 2513826X1771645
Author(s):  
Stahs Pripotnev ◽  
Colin White
Keyword(s):  
Ulnar Nerve ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Dominant Male ◽  
Ulnar Nerve Compression ◽  
Compression Neuropathy ◽  
History Of ◽  
Tunnel Syndrome ◽  
Subcutaneous Transposition ◽  
Abnormal Anatomy

Cubital tunnel syndrome is the second most common compression neuropathy of the upper extremity and the most common point of compression for the ulnar nerve. We present a case of ulnar nerve compression neuropathy at the elbow secondary to an abnormal subluxating medial head of triceps. A 37-year-old right hand dominant male presented with a history of bilateral medial elbow pain and ulnar distribution hand numbness. During his left cubital tunnel release surgery, the abnormal anatomy was noted. Initial subfascial anterior transposition was insufficient and had to be revised to a subcutaneous transposition intraoperatively. Failure to recognize the contribution of triceps abnormalities can lead to incomplete resolution following surgery. Surgeons should be wary of uncommon findings and adjust their approach appropriately.

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.

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 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.

scholarly journals Anterior subcutaneous transposition of the ulnar nerve improves neurological function in patients with cubital tunnel syndrome

2015 ◽  
Vol 10 (10) ◽  
pp. 1690 ◽  
Author(s):  
Tian-bing Wang ◽  
Bao-guo Jiang ◽  
Wei Huang ◽  
Pei-xun Zhang ◽  
Zhang Peng ◽  
...  
Keyword(s):  
Ulnar Nerve ◽  
Cubital Tunnel Syndrome ◽  
Neurological Function ◽  
Cubital Tunnel ◽  
Tunnel Syndrome ◽  
Subcutaneous Transposition
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