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

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.

2003 ◽  
Vol 14 (4) ◽  
pp. 296-301 ◽  
Author(s):  
Robert L. Brady ◽  
Louis W. Catalano ◽  
O. Alton Barron

2020 ◽  
Vol 25 (02) ◽  
pp. 236-239
Author(s):  
Sarah K. Tolerton ◽  
Marco Sinisi ◽  
Paul O’Donnell ◽  
Maxim D. Horwitz

We describe a case of an adult patient presenting with cubital tunnel syndrome in the setting of previously undiagnosed macrodactyly. Early diagnosis and management of macrodactyly is important to help prevent symptoms associated with compromised peripheral nerves and reduce the likelihood of the permanent motor and sensory sequelae of prolonged nerve compression.


Hand ◽  
2019 ◽  
pp. 155894471985781
Author(s):  
Stefano Lucchina ◽  
Cesare Fusetti ◽  
Marco Guidi

Background:The measurement of cross-sectional area (CSA) is a diagnostic tool to detect entrapments syndrome. The aim of this study was to compare the clinical outcome in elbows undergoing endoscopic and “in situ” open cubital tunnel release for cubital tunnel syndrome (CuTS) using ultrasound-related changes in the largest CSA of the ulnar nerve. The purpose is to determine the association between clinical outcome and CSA. Methods: From May 2011 to April 2016, 60 patients with CuTS were prospectively followed and not randomly divided in two groups: 30 patients undergoing an endoscopic release (ER) and 30 patients with “in situ” open neurolysis (OR). A sonographic examination was performed by the senior authors at baseline and 3, 6, and 12 months after surgical decompression. Results: CSA values were statistically significantly lower in the ER. Hand grip strength difference with Jamar test was not statistically significant a 12 months (39 kg vs 27 kg). Static-2 point discrimination test difference was only statistically significant lower in the endoscopic group at 3, 6 and 12 months but not clinically relevant (5 mm vs 6 mm). The American Shoulder and Elbow Surgeons—Elbow questionnaire (ASES-e) function score, ASES-e Pain score, and ASES-e Satisfaction score were not statistically significant different between the two groups at 3, 6, and 12 months post operatively. Conclusions: The study confirms that in spite of lower values of CSA in the ER, there is not a statistically significant difference between the two techniques in terms of subjective outcomes. Ultrasound (US) measurements seem to have a limited value in clinical results of patients treated for entrapment neuropathy of the ulnar nerve. Type of study/LOE: Prognostic Level III


2010 ◽  
Vol 66 (suppl_2) ◽  
pp. ons325-ons332 ◽  
Author(s):  
Axel Thomas Stadie ◽  
Doerthe Keiner ◽  
Gerrit Fischer ◽  
Jens Conrad ◽  
Stefan Welschehold ◽  
...  

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.


Hand Surgery ◽  
2014 ◽  
Vol 19 (03) ◽  
pp. 329-333 ◽  
Author(s):  
Kensuke Ochi ◽  
Yukio Horiuchi ◽  
Toshiyasu Nakamura ◽  
Kazuki Sato ◽  
Kozo Morita ◽  
...  

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.


Hand Surgery ◽  
2015 ◽  
Vol 20 (01) ◽  
pp. 137-139 ◽  
Author(s):  
Yoshihiro Abe ◽  
Masahiko Saito

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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