Analysis the cause of failure in primary surgery of cubital tunnel syndrome and clinical evaluation of revision cubital tunnel surgery

Abstract

Objective To explore the reasons for the failure of primary cubital tunnel syndrome (CuTS) surgery, summarize the technical details of cubital tunnel revision and evaluate the clinical efficacy. Methods From January 2015 to December 2016, 20 patients with persistent or new symptoms of CuTS after primary operation were treated with revision. The technical details of revision of cubital tunnel were summarized and the clinical efficacy was evaluated by observing the compression of ulnar nerve during operation and following up the improvement of clinical symptoms. Results The incomplete release of common compression points of ulnar nerve in elbow and improper preparation of fascial tissue flaps for anterior ulnar nerve were the main reasons for the failure of operation. After at least 12 months of follow-up, the strength of hand intrinsic muscles, skin sensation and pain symptoms of ulnar nerve innervation were significantly improved. Conclusion For the cases of CuTS with severe symptoms or new symptoms after primary operation, the main reason for failure is improper handling of details. The clinical efficacy of revision of CuTS is satisfactory, but it is worse than that of successful primary surgery. Key words: Cubital tunnel syndrome; Treatment failure; Revision; Neuropathic pain; Medial antebrachial cutaneous nerve