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General Orthopaedics

OUTCOME OF CUBITAL TUNNEL DECOMPRESSION: A REVIEW OF 136 CASES

The Indian Orthopaedic Society (UK) (IOSUK)



Abstract

Introduction

Only a few studies have assessed the outcome of ulnar nerve decompression, most comparing various forms of decompression. A review of the case notes of patients undergone ulnar nerve decompressions was undertaken looking at the pre-op symptoms, nerve conduction studies, the co-morbidities, operative procedures and the post-operative outcomes.

Material/methods

We reviewed the case notes of ulnar nerve decompressions surgery performed over a period of six year period. Outcome grading was recorded as completely relieved, improved, unchanged or worse. The significance level was set at 5%.

Results

A total of 136 ulnar nerve decompressions formed the study group. Numbness and paraesthesia in ulnar distribution were the two most common presenting symptoms (96%). Majority (68%) had symptoms for over a year before surgery. Simple decompression was done in 110 extremities and rest of the cases required additional anterior subcutaneous transposition. The cause of compression was identified as idiopathic in 58.2%; flexor carpi ulnaris aponeurosis in 36.7% and Arcade of Struthers in 5.1% extremities. The outcome was satisfactory in 85.2% of patients. No obvious association was demonstrated between the outcome of surgery and duration of symptoms, presence of co-morbidities or the type of surgery performed. Interestingly out of 12 patients who got worse or had no improvement, nine (75%) had either normal nerve conduction studies or none done pre-operatively.

Conclusions

This is the largest review of outcomes after ulnar nerve decompressions at elbow. The study showed that good results (85.2%) in majority of patients regardless of level of surgeon's experience or procedure undertaken.