Simple Decompression versus Anterior Submuscular Transposition of the Ulnar Nerve in Severe Cubital Tunnel Syndrome: A Prospective Randomized Study

Neurosurgery ◽  
2005 ◽  
Vol 56 (1) ◽  
pp. 108-117 ◽  
Author(s):  
Olga Gervasio ◽  
Giuseppe Gambardella ◽  
Claudio Zaccone ◽  
Damiano Branca
Keyword(s):  
Ulnar Nerve ◽  
Randomized Study ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Prospective Randomized Study ◽  
Significant Difference ◽  
Group A ◽  
Tunnel Syndrome ◽  
Group B ◽  
Simple Decompression

Abstract OBJECTIVE: The authors report the results of a clinical series of selected patients with severe cubital tunnel syndrome. The degree of ulnar nerve compression was evaluated by use of a grading system that includes measurements of motor and sensitive function. The submuscular transposition with flexor-pronator mass Z lengthening was compared with simple decompression through a prospective randomized study. METHODS: From February 1998 to June 2003, 70 patients with severe cubital tunnel syndrome were included in this study: 35 patients were submitted to simple decompression (Group A), and 35 patients were treated by anterior deep submuscular transposition (Group B). The preoperative status was determined by use of Dellon's classification. The selected patients had Dellon's Grade 3 (severe syndrome). The mean follow-up period after surgery was 47 months for Group A and 46.94 months for Group B. RESULTS: Postoperative clinical and electrophysiological outcomes were assessed 6 months after surgery in all 70 patients. According to the Bishop scoring system, 19 patients (54.3%) of Group A were clinically graded as excellent, 9 (25.7%) were graded as good, and 7 (20%) were graded as fair; in Group B, 18 patients (51.43%) were graded as excellent, 11 (31.43%) as good, and 6 (17.14%) as fair. Neither severe complications nor recurrences were observed in the two groups. CONCLUSION: No statistically significant difference was found between the two groups with regard to the clinical or the electrophysiological outcome. The surgical treatment gains in Group A and B were 80% and 82.86%, respectively (good to excellent results).

scholarly journals Relationship between Smoking and Outcomes after Cubital Tunnel Release

2018 ◽  
Vol 10 (01) ◽  
pp. 012-015
Author(s):  
Nicholas Crosby ◽  
Naveed Nosrati ◽  
Greg Merrell ◽  
Hill Hasting
Keyword(s):  
Ulnar Nerve ◽  
Cubital Tunnel Syndrome ◽  
Smoking History ◽  
Cubital Tunnel ◽  
Nerve Decompression ◽  
Pain Scores ◽  
Significant Difference ◽  
Tunnel Syndrome ◽  
Simple Decompression ◽  
Postoperative Improvement

Abstract Purpose Several studies have drawn a connection between cigarette smoking and cubital tunnel syndrome. One comparison article demonstrated worse outcomes in smokers treated with transmuscular transposition of the ulnar nerve. However, very little is known about the effect that smoking might have on patients who undergo ulnar nerve decompression at the elbow. The purpose of this study is to evaluate the effect of smoking preoperatively on outcomes in patients treated with ulnar nerve decompression. Materials and Methods This study used a survey developed from the comparison article with additional questions based on outcome measures from supportive literature. Postoperative improvement was probed, including sensation, strength, and pain scores. A thorough smoking history was obtained. The study spanned a 10-year period. Results A total of 1,366 surveys were mailed to former patients, and 247 surveys with adequate information were returned. No significant difference was seen in demographics or comorbidities. Patients who smoked preoperatively were found to more likely relate symptoms of pain. Postoperatively, nonsmoking patients generally reported more favorable improvement, though these findings were not statistically significant. Conclusion This study finds no statistically significant effect of smoking on outcomes after ulnar nerve decompression. Finally, among smokers, there were no differences in outcomes between simple decompression and transposition.

Comparing endoscopic and open decompression of the ulnar nerve in cubital tunnel syndrome: a prospective randomized study

2018 ◽  
Vol 160 (10) ◽  
pp. 2011-2017 ◽  
Author(s):  
T. Krejčí ◽  
Z. Večeřa ◽  
O. Krejčí ◽  
D. Šalounová ◽  
M. Houdek ◽  
...  
Keyword(s):  
Ulnar Nerve ◽  
Randomized Study ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Prospective Randomized Study ◽  
Tunnel Syndrome

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.

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.

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

A Novel Diagnostic and Prognostic Tool for Simple Decompression of Ulnar Nerve in Cubital Tunnel Syndrome

2018 ◽  
Vol 118 ◽  
pp. e964-e973 ◽  
Author(s):  
Domenico La Torre ◽  
Giovanni Raffa ◽  
Maria Angela Pino ◽  
Vincenzo Fodale ◽  
Vincenzo Rizzo ◽  
...  
Keyword(s):  
Ulnar Nerve ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Prognostic Tool ◽  
Tunnel Syndrome ◽  
Simple Decompression

Outcome Study of Ulnar Nerve Compression at the Elbow Treated with Simple Decompression and an Early Programme of Physical Therapy

1995 ◽  
Vol 20 (5) ◽  
pp. 628-637 ◽  
Author(s):  
P. A. NATHAN ◽  
R. C. KENISTON ◽  
K. D. MEADOWS
Keyword(s):  
Physical Therapy ◽  
Return To Work ◽  
Ulnar Nerve ◽  
Rehabilitation Program ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Tunnel Syndrome ◽  
Simple Decompression

Cubital tunnel syndrome is the second most common entrapment neuropathy of the upper limb. This paper presents the experience of treating cubital tunnel syndrome with simple decompression in 131 patients (164 ulnar nerves) over the past 12 years. 85% of these patients had mild or moderate ulnar nerve disease. In 146/164 ulnar nerves (89%), simple decompression resulted in good or excellent immediate post-operative relief of symptoms. After an average follow-up of 4.3 years (range, 0.8–12.0 years), 130/164 (79%) still reported good or excellent relief. The independent predictors of a better long-term outcome were absence of post-operative subluxation, greater body weight, normal pre-operative two-point discrimination (2-PD), and a more recent date of operation. A physical therapy rehabilitation program generally began on the day after surgery. Active participation in this predicted a rapid return to work or activities of daily living. The average time to return to work with simple decompression was 20 workdays.

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.

CUBITAL TUNNEL SYNDROME ASSOCIATED WITH ARTHROGRYPOSIS: A CASE REPORT

Hand Surgery ◽  
2012 ◽  
Vol 17 (01) ◽  
pp. 85-87
Author(s):  
Makoto Motomiya ◽  
Norimasa Iwasaki ◽  
Akio Minami
Keyword(s):  
Case Report ◽  
Ulnar Nerve ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Good Recovery ◽  
Fibrous Band ◽  
Trunk Sway ◽  
Tunnel Syndrome ◽  
Simple Decompression ◽  
Elbow Motion

Arthrogryposis is a syndrome of multiple joint contracture and subluxation that is present at birth and is characterized by a nonprogressive disorder. Patients with lack of active elbow motion show the typical elbow motion with passive assistance, such as the trunk-sway and cross-arm techniques. We describe our experience with the treatment of an arthrogryposis patient with cubital tunnel syndrome caused by the passive elbow motion. The ulnar nerve was entrapped by a thick fibrous band at the cubital tunnel, and simple decompression of the ulnar nerve brought the patient a good recovery from the palsy.

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