SURGICAL MANAGEMENT OF CUBITAL TUNNEL SYNDROME

Abstract

Purpose: We perform the results of the operative treatment of cubital tunnel syndrome, and a retrospective review of the surgical options of in situ decompression of the ulnar nerve, release and anterior transposition of the ulnar nerve and ulnar nerve release and partial medial epicondylectomy.

Material and Methods: Seventy four patients, 52 male and 22 female, (78 elbows), were treated surgically from October 1991 to November 2002.The mean age was 51 years (range, 13 to 72 years). Sixty four patients were assessed postoperatively with mean follow-up 80 months (range 6–139 months). Twenty patients underwent in situ decompression of the ulnar nerve, 34 patients release and anterior transposition and 14 ulnar nerve release and partial medial epicondylectomy. According to the McGowing evaluation system were classified in Grade I, none, Grade II, 38 patients and Grade III 26 patients. The 64 patients were evaluated clinically and 16 of them by EMG studies postoperatively.

Results: Sixty one patients had had subjective improvment of their symptoms. Thirty seven patients (57.8%) excellent, 21 patients (32.8%) good, 3 patients (4.6%) fair and 3 patients (4.6%) poor results. (Wilson & Krout). The comperative results among the surgical options of our study showed improvement in the subjective outcome of 32 out of 34 patients who had release and anterior transposition of the ulnar nerve. From the 20 patient who had in situ decompression of the ulnar nerve, 19 had improvement and from the rest 14 patients who had had ulnar nerve release and partial medial epicondylectomy, they all had improvement.

Conclusions: The results for the patients in this study who had ulnar nerve release and partial medial epicondylectomy, are comparable in good results with other operative treatment options for the cubital tunnel syndrome.