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

Abstract

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.

Evaluation of the Results of Surgical Treatment and Rehabilitation of Cubital Tunnel Syndrome

“…In this study the syndrome was present in 57% of women and affected the left side in 62%. Kamat et al (2014) and Jeon et al (2010) confirmed that the syndrome was more prevalent in women and Kanat et al (2014) confirmed that it involved primarily the upper left limb. Perhaps this is the consequence of women, undertaking jobs previously performed by men.…”

Surgical Approaches and Their Outcomes in the Treatment of Cubital Tunnel Syndrome

“…A study of 66 patients in 2010 by Jeon et al with 81% of patients with preoperative McGowan stage 1 and 2 having satisfactory outcomes (Me) with a 3% postoperative complication rate of 2 hematomas ( 35 ). Karthik et al demonstrated a CGE of 80% ( n = 46, B) ( 36 ) and Lan et al had a procedural satisfaction rate of 88% with 70% showing symptomatic improvement ( 37 ) (Table 2C ).…”

Nerve Injuries About the Elbow in the Athlete

“…15 On the basis of the literature's largest systematic review of patient's with ulnar neuropathy (over 2000 patients) following in situ decompression in nonthrowers, both subjective and objective patient-reported clinical outcome measures have illustrated no significant differences in patient satisfaction, pain relief, return to activities (including sports), and scar tenderness versus subcutaneous transposition. 16,17 Unfortunately, the latter lacked any randomized controlled clinical trials and included only 2 prospective cohort studies. Patients with mild or moderate (McGowan Classification grade 1 or 2) ulnar nerve injury have significantly better outcomes than those with severe (McGowan grade 3) injury.…”