J Korean Neurotraumatol Soc.  2009 Jun;5(1):16-21. 10.13004/jknts.2009.5.1.16.

Minimally Invasive Ulnar Nerve Decompression for Cubital Tunnel Syndrome

• Cho YJ
• Cho SM
• Sheen SH
• Heo DH
• Cho JH
• Oh SM

• KMID: 2019928
• DOI: http://doi.org/10.13004/jknts.2009.5.1.16

Abstract

OBJECTIVE
The purpose of this study is to present the efficacy of the surgical technique using a minimal skin incision for the treatment of cubital tunnel syndrome. Ulnar nerve entrapment at the elbow is the second most common compression neuropathy of the upper extremity. Surgical treatment of conventional simple decompression of ulnar nerve is considered to be relatively safe and reliable. However, this surgical technique is needed a relatively long incision and often can result in significant postoperative scarring and delay in return to work.
METHODS
Ten patients with cubital tunnel syndrome underwent simple decompression using a 2 cm or less skin incision. According to Dellon's criteria, one elbow was classified as grade 1, four as grade 2, and five as grade 3. Preoperative electrodiagnostic studies were performed on all patients and 6 of them were rechecked postoperatively.
RESULTS
Preoperative motor conduction velocity (MCV) within the segment was 35.5+/-16.2 m/s and decreased than the result of MCV in the below the elbow-wrist segment (59.3+/-5.9 m/s, p<0.05). Postoperative results of MCV were improved in all patients from 37.1+/-13.2 m/s to 51.9+/-8.9 m/s (p<0.05). After an average follow-up of 5.9+/-5.0 months, all patients were reported to be in good or excellent condition.
CONCLUSION
We could observe an enough distance of the ulnar nerve from proximal to distal area without difficulty using manual retraction. Simple decompression through a small skin incision can be recommended for the treatment of cubital tunnel syndrome, if the indication is appropriate.

Keyword

Cubital tunnel syndrome; Ulnar nerve; Minimally invasive

MeSH Terms

Cicatrix
Cubital Tunnel Syndrome
Decompression
Elbow
Follow-Up Studies
Humans
Skin
Ulnar Nerve
Ulnar Nerve Compression Syndromes
Upper Extremity

Figure

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  FIGURE 1 Skin marking at left elbow for simple decompression of ulnar nerve using a small incision. A 2 cm skin incision made between the medial epicondyle (E) and olecranon (O). Left side of photo is proximal.

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  FIGURE 2 Intraoperative photo shows the ulnar nerve (asterisk) and Osborne's ligament (black arrow).

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  FIGURE 3 The skin is retracted to distal side with a retractor. The released ulnar nerve (asterisk) and a head of flexor carpi ulnaris muscle (black arrow) are seen.

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  FIGURE 4 The skin is retracted to proximal side with a retractor. The ulnar nerve (asterisk) is released.

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