Surgical Treatment for Ulnar Nerve Entrapment at the Elbow

Asamoto, Shunji; Böker, Dieter-Karsten; Jödicke, Andreas

doi:10.2176/nmc.45.240

Cited by 31 publications

(26 citation statements)

References 41 publications

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“…Our study findings are in line with the published literature [2,[5][6][7][8][9][10][11]. In most of our patients with cubital tunnel syndrome, symptoms improved within the first year post-operatively, and returning to full activity was fast and was in about 12 days, which could be due to early initiation of ROM after operation with this surgical techniques; these results are also in consistent with previous studies [6].…”

Section: Discussionsupporting

confidence: 93%

“…In 1930-1940, Learmonth described ulnar nerve compression in the elbow, and subsequently introduced methods for decompression and transposition of compressed nerve [1]. The term "Cubital Tunnel Syndrome" was first introduced by Feindel and Startford in 1958 [2]. This syndrome is the most common compression neuropathy after carpal tunnel syndrome [1,2].…”

Section: Introductionmentioning

confidence: 99%

“…The term "Cubital Tunnel Syndrome" was first introduced by Feindel and Startford in 1958 [2]. This syndrome is the most common compression neuropathy after carpal tunnel syndrome [1,2]. This syndrome presents with tingling, numbness (fourth and fifth fingers), and weakness in the hands, and inability to perform fine movements.…”

Section: Introductionmentioning

confidence: 99%

“…Earlier reports have demonstrated that anterior subcutaneous transposition of ulnar nerve had good and excellent results ranging from 65% to 90% [2,[5][6][7][8][9][10][11]. Although results of this procedure has been published, but results are variable between articles [2,[5][6][7][8][9][10][11], additional studies that use reproducible preoperative and postoperative objective measures have been reported to be necessary to make a reliable decision on different surgical techniques [12].…”

Section: Introductionmentioning

confidence: 99%

“…Although results of this procedure has been published, but results are variable between articles [2,[5][6][7][8][9][10][11], additional studies that use reproducible preoperative and postoperative objective measures have been reported to be necessary to make a reliable decision on different surgical techniques [12].…”

Section: Introductionmentioning

confidence: 99%

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Anterior subcutaneous transposition of ulnar nerve with fascial flap and complete excision of medial intermuscular septum in cubital tunnel syndrome: A prospective patient cohort

Aslani

Abrishami

Mohammadreza

et al. 2011

Clinical Neurology and Neurosurgery

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a b s t r a c tObjective: Regarding the frequency of cubital tunnel syndrome, varieties of treatment modalities, and ambiguity of anterior subcutaneous transposition of ulnar nerve method, we aimed to evaluate the efficacy of this procedure in patients with cubital tunnel syndrome referred to Taleghani hospital between 2006 and 2009. Methods: This study was a case series including all referred patients with definite diagnosis of cubital tunnel syndrome, treated by anterior subcutaneous transposition. Treatment results were measured according to modified Bishop rating system, and were ranked into excellent, good, fair, and poor. Variables such as gender, age (less/more than 45 years), causation, and initial severity, determined by Dellon criteria preoperatively, were analyzed by Fisher's exact test. Results: This study was performed on 26 eligible cases including 29 elbows, 38% males and 62.1% females, with mean age of 44.5 years (ranging 23-72 years). In a 12 months follow-up post-operatively, 62% showed excellent, 20.7% good, and 17.3% fair, with no poor result. In a 1-12 months follow-up post-operatively, results showed improvement, and initial severity and old age were demonstrated to significantly affect treatment results (P < 0.07). Conclusion: Though considered standard of care, the present study suggests that criteria for surgical techniques of ulnar nerve decompression, e.g. simple decompression vs. more extensive repair as in the present cohort, should be revised by controlled prospective studies.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Anterior subcutaneous transposition of ulnar nerve with fascial flap and complete excision of medial intermuscular septum in cubital tunnel syndrome: A prospective patient cohort

Aslani

Abrishami

Mohammadreza

et al. 2011

Clinical Neurology and Neurosurgery

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Safety and Outcomes of Different Surgical Techniques for Cubital Tunnel Decompression

et al. 2020

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IMPORTANCE Cubital tunnel syndrome is the second most common compressive neuropathy, affecting 6% of the population. Numerous different operations are performed globally to treat it; however, prior conventional (pairwise) meta-analyses have been unable to determine which procedure is associated with the best outcomes and fewest complications. OBJECTIVE To evaluate which operation for cubital tunnel syndrome is associated with the greatest likelihood of symptomatic cure. DATA SOURCES PubMed, EMBASE, and CENTRAL were searched from database inception to March 2, 2019, with no restrictions on the setting or design of studies. STUDY SELECTION Experimental and observational studies directly comparing the outcomes of at least 2 surgical treatments for adults with primary cubital tunnel syndrome were included. Case reports were excluded, and when comparative studies had subgroups with 1 participant, the singleparticipant subgroup was excluded. The treatments had to be in situ decompression with or without medial epicondylectomy or an anterior subcutaneous, subfascial, intramuscular, or submuscular transposition. The access could be open, minimally invasive, or endoscopic. The comparator could be sham surgery or any operation mentioned earlier. DATA EXTRACTION AND SYNTHESIS Data were extracted by 2 independent reviewers, following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline and the PRISMA Network Meta-analysis extension statement. Network meta-analysis was used to estimate the relative efficacy and safety associated with interventions using relative risks. Surgical techniques were ranked by their probability of being the best (P score) and interpreted in terms of their clinical impact. MAIN OUTCOMES AND MEASURES The primary outcome was response to treatment (ie, symptomatic improvement). The secondary outcomes were perioperative complications, reoperation, and recurrence. RESULTS A total of 30 studies of 2894 limbs undergoing 8 different operations were included. Across the studies, 56% of participants were men, the mean (SD) age was 48 (8) years, and patients had symptoms for a mean (SD) of 15 (7) months. Overall, 87% (95% CI, 92%-91%) of patients improved with surgery; all forms of in situ decompression were more effective than any type of transposition procedure; for example, open in situ decompression with epicondylectomy was (continued) Key Points Question For adults with primary cubital tunnel syndrome, which operation is associated with the best chance of symptomatic cure and lowest risk of complications? Findings This network meta-analysis included 30 studies comparing 8 different operations in 2894 limbs. It found that 87% of patients improve with surgery and that open in situ decompression (with or without a medial epicondylectomy) was associated with the greatest response to treatment and lowest complication risk. Meaning The findings of this study suggest that for adults with primary cubital tunnel syndrome, the most beneficial operation appears to be ope...

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