Simple Decompression of the Ulnar Nerve for Cubital Tunnel Syndrome

Cho, Yong‐Jun; Cho, Sung Min; Sheen, Seung-Hoon; Choi, Jong-Hun; Huh, Dong-Hwa; Song, Juyeon

doi:10.3340/jkns.2007.42.5.382

Cited by 29 publications

(22 citation statements)

References 28 publications

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“…a simple release of structures affecting the ulnar nerve (e.g. Osbourne´s ligament and the arcade at the two heads of flexor carpi ulnaris muscle, over a limited distance) [15] is equal to that of both subcutaneous and submuscular transposition [16][17][18], but with a lower risk of postoperative complications [16,17]. The less invasive, and surgically easier, simple decompression is by some therefore considered as the gold standard when treating the majority of primary UNE cases surgically.…”

Section: Introductionmentioning

confidence: 99%

Outcome and predictors in simple decompression of ulnar nerve entrapment at the elbow

Anker¹,

Zimmerman²,

Andersson³

et al. 2018

Hand Microsurg

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Objectives:Simple decompression is an accepted surgical treatment of ulnar nerve entrapment at the elbow (UNE). Our purpose was to evaluate the outcome and potential predictors for the outcome after simple decompression in UNE. Methods: All surgically treated UNE cases (from 2004-2008) at our department were studied retrospectively. Out of 285 primary surgeries, 242 primary simple ulnar nerve decompressions were included. Medical records, including electrophysiologic protocols, were reviewed and postoperative outcome was graded: 1) cured/improved and 2) unchanged/worsened symptoms, based on surgeon-evaluated outcome. Results: Of the 242 simple decompressions (122 males and 120 females; median age 50.5 years), 101 cases were students, retired, un-employed, or on a long-term sick-leave and 112 had manual, blue-collar type of work. 189 cases were cured or improved, while 53 cases had no change in, or even worsened, symptoms. Gender, presence of smoking, or associated diseases did not affect outcome, while a tendency was observed for higher age, a manual occupation and constant symptoms. Out of 196 cases electrophysiologically examined, 155 cases showed signs of ulnar nerve affection (56 reduced conduction velocity; 19 conduction block; 80 axonal degeneration; latter two groups significantly worse outcome). Conclusion: Patients with a preoperatively electrophysiologically diagnosed nerve conduction block or axonal degeneration have higher risk of not being cured or improved after simple decompression in UNE. Older patients, those with a manual profession, and constant symptoms of UNE tend to be less improved after surgery.

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Section: Introductionmentioning

confidence: 99%

Outcome and predictors in simple decompression of ulnar nerve entrapment at the elbow

Anker¹,

Zimmerman²,

Andersson³

et al. 2018

Hand Microsurg

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“…As for surgical technique, subcutaneous or submuscular anterior transposition of the ulnar nerve [2], simple in situ decompression [3,4], medial epicondylectomy [5] are reported. Simple in situ decompression method is indicated if there is no cubitus valgus deformity or subluxation of the ulnar nerve.…”

Section: Discussionmentioning

confidence: 99%

“…As for surgery methods, anterior transposition of the ulnar nerve [2], simple in situ decompression [3,4], medial epicondylectomy [5,6] are reported. Passive hyperextension of the elbow and wrist joint is recommended to improve the excursion of the ulnar nerve as a physical therapy.…”

Section: Introductionmentioning

confidence: 99%

Simple in situ decompression for idiopathic cubital tunnel syndrome using minimal skin incision

Jeon

Micić²,

Lee

et al. 2010

Med pregl

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Cubital tunnel syndrome is one of the most frequently occurring compression neuropathy in the upper limb next to carpal tunnel syndrome. Recent minimal invasive technique has prompted us to gain clinical experience with simple in situ decompression with minimal skin incision for idiopathic cubital tunnel syndrome. Sixty six consecutive patients with cubital tunnel syndrome were treated using minimal skin incision technique. The mean age of the patients was 49.7 (range: 15-77) years and average follow up period was 23.9 months (range: 12-60 months). The severity of ulnar neuropathy was classified according to the McGowan classification: there were 17 in grade I, 47 in grade II and 2 in grade III. A preoperative nerve conduction study was done by inching method, which revealed motor conduction delay around the medial epicondyle. All operations were carried out in a day surgery unit under local anesthetics. The postoperative outcome was evaluated by Messina classification. The mean duration of the operation was 12 minutes. The technique was highly satisfactorily esthetic for all. Over 80% of the patients were completely satisfied with the procedure taking into consideration their symptoms. Postoperative outcome measures and patient satisfactions (pain, return to normal activities and work, scar and pillar tenderness) were comparable with published series of anterior transposition. The overall satisfactory results were recorded 81% in the patients of McGowan stage I and II. There were 2 cases of hematoma as a postoperative complication. This procedure is comparably effective alternative which involves less surgical trauma, morbidity and rehabilitation time with good surgical outcomes especially in mild and moderate degrees. Minimal skin incision is a simple, safe and effective method to treat patients with idiopathic cubital tunnel syndrome.

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“…Others with endoscopic assistance have reported no nerve constriction beyond 4 cm distally or proximally to the retroepicondylar tunnel [100]. So, extensive proximal decompression seems futile [100,114]. Unsatisfactory results have been related to concomitant undiagnosed CTS or to weight gain [107].…”

Section: Peripheral Nerve Regeneration -From Surgery To New Therapeutmentioning

confidence: 99%

Peripheral Nerve Entrapment and their Surgical Treatment

Vanaclocha‐Vanaclocha¹,

Saiz-Sapena²,

MaríaOrtiz‐Criado³

et al. 2017

Peripheral Nerve Regeneration - From Surgery to New Therapeutic Approaches Including Biomaterials and Cell-Based Therapies Deve

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Nerves pass from one body area to another through channels made of connective tissue and/or bone. In these narrow passages, they can get trapped due to anatomic abnormalities, ganglion cysts, muscle or connective tissue hypertrophy, tumours, trauma or iatrogenic mishaps. Nearly all nerves can be affected. The clinical presentation is pain, paraesthesia, sensory and motor power loss. The specific clinical features will depend on the affected nerve and on the chronicity, severity, speed and mechanism of compression.Its incidence is higher under some occupations and is some systemic conditions: diabetes mellitus, hypothyroidism, acromegaly, alcoholism, oedema and inflammatory diseases. The diagnosis is suspected with the clinical presentation and provocative clinical test, being confirmed with electrodiagnostic and/or ultrasonographic studies. Magnetic Resonance Studies (MRI) rule out ganglion cysts or tumours. Conservative medical treatment is often sufficient. In refractory ones, surgical decompression should be performed before nerve damage and muscle atrophy are irreversible. The 'double crash' syndrome happens when a peripheral nerve is compressed at more than one point along its trajectory. In cases with marked muscle atrophy, a 'supercharge end-to-side' nerve transfer can be added to the decompression. After decompression in those few cases with refractory pain, a nerve neurostimulator can be applied.

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Simple Decompression of the Ulnar Nerve for Cubital Tunnel Syndrome

Abstract: Simple decompression of the ulnar nerve is an effective and successful minimally invasive technique for patients with cubital tunnel syndrome.

Cited by 29 publications

References 28 publications

Outcome and predictors in simple decompression of ulnar nerve entrapment at the elbow

Outcome and predictors in simple decompression of ulnar nerve entrapment at the elbow

Simple in situ decompression for idiopathic cubital tunnel syndrome using minimal skin incision

Peripheral Nerve Entrapment and their Surgical Treatment

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