Abstract
Aim: Aim of this study is to determine if cubital tunnel view radiograph of the elbow is useful in the investigation and treatment of Ulnar nerve entrapment at the elbow.
Patients and Methods: 28 patients presenting with symptoms suggestive of ulnar nerve entrapment at the elbow were prospectively studied. Detailed history and clinical examination was elicited in each patient and classified according to McGowan’s classification. Diagnosis of ulnar nerve entrapment at the elbow was confirmed by nerve conduction studies. Cubital tunnel view radiographs were taken and evaluated for any evidence of bony encroachment of the ulnar nerve bed in the cubital tunnel. Those patients with normal cubital tunnel view radiograph underwent simple ulnar nerve decompression where as those with significant bony encroachment of ulnar nerve bed underwent anterior transposition of the ulnar nerve. The results of surgery were assessed at follow up using the Wilson and Krout criteria. The difference in results in two groups was statistically analyzed by applying student ‘t’ test.
Results: There were 20 patients (male=14, female 6) in the simple ulnar nerve decompression group with a mean age of 52 yrs (range 32 to 61 yrs) and 8 patients (male=6, female=2) in anterior transposition group with a mean age 59 yrs (range 45 to 69 yrs). Mean follow up was 25months (range 9 months to 32 months). According to McGowan’s classification there were 5 grade I, 9 grade II and 6 grade III patients in simple decompression group where as there were none grade I, 3 grade II and 5 grade III in anterior transposition group. All patients had neurophysiological evidence of ulnar nerve entrapment in pre-operative nerve conduction study. Wilson and Krout grading at final follow up showed 15 good, 4 fair and 1 poor result in simple decompression group and 5 good, 2 fair and 1 poor result anterior transposition group. There was no statistically significant difference between the two groups (p value < 0.001).
Conclusion: Cubical tunnel view radiographs are valuable in the management of ulnar nerve entrapment at the elbow. Patients with normal radiograph can be treated by simple nerve decompression
Correspondence should be addressed to Ms Larissa Welti, Scientific Secretary, EFORT Central Office, Technoparkstrasse 1, CH-8005 Zürich, Switzerland
