Abstract
BackgroundUlnar neuropathy is a common reason for referral to hand surgeons, and 10 to 30% of cubital tunnel syndrome (CuTS) is idiopathic. We hypothesized that the cause of idiopathic CuTS is in the bony structure.MethodsWe analyzed 79 elbows (39 idiopathic CuTS and 40 without CuTS symptom) using computed tomography and Materialize Mimics software to compare the differences between the two groups. We proposed a new bony cubital tunnel with a new boundary that could play a role in ulnar nerve compression symptom.ResultsThe mean cubital tunnel volume was 1245.6 mm3 in all patients, 1180.6 mm3 in CuTS patients, and 1282.3 mm3 in the control group. A significant difference (p = 0.015) between two groups was found. Bony cubital tunnel cross-sectional area, cubital tunnel depth, and cubital tunnel angle also showed significant differences.ConclusionThe shape of the bony cubital tunnel is an important cause of CuTS, and the normal variation of the volume and cross-sectional area of the cubital tunnel and cubital tunnel angle could influence the occurrence of idiopathic CuTS.
Highlights
Ulnar neuropathy is a common reason for referral to hand surgeons, and 10 to 30% of cubital tunnel syndrome (CuTS) is idiopathic
The bony cubital tunnel was assumed to be a semi-circular tunnel with a line connecting the center of the trochlear and the medial epicondyle (Fig. 1), and the bony structure was analyzed in the elbow full flexion state
There was no significant difference between the two groups according to the degree of elbow flexion, affected side, humerus axis and axis of bony cubital tunnel (ABT)
Summary
Ulnar neuropathy is a common reason for referral to hand surgeons, and 10 to 30% of cubital tunnel syndrome (CuTS) is idiopathic. Cubital tunnel syndrome (CuTS) is one of the most frequently occurring compression neuropathies in the upper extremity [1, 2]. Causes of CuTS include elbow osteoarthritis, constriction of the cubital tunnel retinaculum, medial elbow ganglions, ulnar nerve subluxation, contusion, and cubitus varus or valgus deformities. Previous studies have measured cubital tunnels by transforming them into curves centered on the medial epicondyle. The bony cubital tunnel was assumed to be a semi-circular tunnel with a line connecting the center of the trochlear and the medial epicondyle (Fig. 1), and the bony structure was analyzed in the elbow full flexion state
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