Minimal Epicondylectomy Improves Neurologic Deficits in Moderate to Severe Cubital Tunnel Syndrome

Abstract

Background Previous studies of minimal medial epicondylectomy for cubital tunnel syndrome included patients with mild disease, making it difficult to determine how much this procedure improved sensory and motor impairments in patients with moderate to severe disease. Questions/purposes We asked if minimal epicondylectomy improved sensory and motor impairments in patients with moderate to severe cubital tunnel syndrome. Methods We retrospectively reviewed 25 patients treated with minimal medial epicondylectomy for advanced cubital tunnel syndrome involving motor weakness between

Results after simple decompression of the ulnar nerve in cubital tunnel syndrome

“…The standard methods for surgery include simple nerve-decompression, different types of transposition of the ulnar nerve, and medial epicondylectomy. However, there is no evidence for any of them to deliver significantly better results than one of the other techniques [ 2 ], [ 3 ], [ 4 ].…”

Current diagnostics and treatment of the cubital tunnel syndrome in Austria

“…Epicondylectomy is common in some centers and then performed with comparable results [ 6 ], [ 7 ], in Austria it is used as an additional option in recurrent compression or pathology in local bone anatomy.…”

A simple, safe and reliable surgical landmark for medial epicondylectomy

“…This may be a result of the inherent stability of the elbow and also because, even when the aim of surgery is a complete medial epicondylectomy, this is often not actually performed [8,14]. Although there is limited evidence that a larger bony resection yields superior clinical results [18], an incomplete epicondylectomy is an effective technique [8][9][10][11]13,14,[20][21][22][23]. A subtotal (partial) epicondylectomy was first described by Kaempfe and Farbach [7].…”

“…Other studies have dissected the anterior band of the UCL and performed the osteotomy at its medial margin [14,21,24]. An alternative description is to excise a fragment of a particular size; this is variable, ranging from 2 mm to 8 mm [7][8][9][10][11]13]. Because of the disadvantages of the various described techniques to elect a site of bony resection, we have investigated the efficacy and safety of a method utilizing the ulnar nerve itself as a landmark in 90 of elbow flexion.…”

“…To avoid this complication, a partial ME has been described that preserves the UCL [7]. The recommended amount of bone to be excised has varied: on the basis of an anatomical study, it was recommended to excise less than 20% of the epicondyle, whereas other studies have recommended dissecting the ligament and making an osteotomy level with its medial margin or removing a fragment of bone of a specific size [7][8][9][10][11][12][13]. During surgery, it is time-consuming to dissect out the entire width of the epicondyle and perform measurements to plan the osteotomy based on the percentage of epicondyle to be removed.…”