Cubital Tunnel Syndrome: Recent Trends of Treatment

Huh, Sung Woo; Lee, Joo Yup

Abstract

Cubital tunnel syndrome is the second most common nerve entrapment syndrome affecting the upper extremity. Surgical treatment is indicated for those who have motor weakness or when conservative measures have failed. Several different surgical techniques have been introduced, however, the optimal treatment for cubital tunnel syndrome is still under debate. In the recent years, well-performed prospective randomized studies show that there is no difference in outcome among various surgical techniques regardless of the severity and presence of subluxation. It is advised that in situ decompression is the preferred technique because it is simpler and less time consuming procedure. Although in situ decompression is effective in uncomplicated ulnar nerve subluxation, anterior transposition should be considered when the subluxation is painful or when the ulnar nerve actually snaps back and forth over the medial epicondyle. Anterior transposition of the ulnar nerve is still indicated for revision surgery, previous trauma around the elbow, distal humerus fractures, severe osteoarthritis needing medial spur excision, and severe valgus deformity of the elbow.