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Abstract
ObjectiveThe purpose of this study was to compare the clinical outcomes of ulnar nerve stability-based surgery via a small incision with those of classic anterior transposition of the ulnar nerve for cubital tunnel syndrome.MethodsFrom March 2008 to December 2013, 107 patients with cubital tunnel syndrome underwent simple decompression or anterior transposition via a small incision, according to an ulnar nerve stability-based decision based on an assessment of intraoperative ulnar nerve stability (group A, n = 51), or anterior transposition via a classic incision (group B, n = 56). Clinical outcome was assessed using grip and pinch strength, two-point discrimination, the mean of the disabilities of arm, shoulder, and hand (DASH) survey, and the modified Bishop scale.ResultsAt the final follow-up, all outcome measures improved significantly in both groups and there were no significant differences between the two groups. However, there were fewer operation-related complications in group A (one revision surgery) than in group B (one superficial infection, two painful scars, and five cases of numbness at the medial elbow).ConclusionsOutcomes after the ulnar nerve stability-based approach and anterior transposition were similar, although more patients experienced operation-related complications after anterior transposition via a classic incision. Making an ulnar nerve stability-based decision to perform either simple decompression or anterior transposition via a small incision seems to be a better strategy for patients with cubital tunnel syndrome.
Highlights
Cubital tunnel syndrome is the second most common upper-extremity compressive neuropathy, after carpal tunnel syndrome
Studies have investigated the outcomes of operative techniques for treating cubital tunnel syndrome including open [1, 2] or endoscopic [3, 4] simple decompression; subcutaneous [5,6,7], intramuscular [8], or submuscular [2, 9] anterior transposition; and medial epicondylectomy [6, 10, 11]
The most commonly used procedure for operative treatment of cubital tunnel syndrome is anterior transposition of the ulnar nerve, as this procedure can decrease the tension of the ulnar nerve that occurs with elbow flexion [12,13,14]
Summary
Cubital tunnel syndrome is the second most common upper-extremity compressive neuropathy, after carpal tunnel syndrome. Studies have investigated the outcomes of operative techniques for treating cubital tunnel syndrome including open [1, 2] or endoscopic [3, 4] simple decompression; subcutaneous [5,6,7], intramuscular [8], or submuscular [2, 9] anterior transposition; and medial epicondylectomy [6, 10, 11]. Simple decompression only relieves direct compression of the nerve and does not require extensive dissection; it cannot be used to treat dynamic ulnar nerve compression [14]. Another concern of simple decompression is that transposition after a failed simple decompression is likely to be more difficult
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