Comparative Study between In Situ Decompression of the Ulnar Nerve and Medial Epicondylectomy for Cubital Tunnel Syndrome

Lee, Sang Seon; Park, Jong Seok; Hong, Chang Hwa; Awe, Soo Ik; Jung, Ki Jin; Kim, Woo Jong

Abstract

PURPOSE
We present our experience of operative results between in situ decompression of the ulnar nerve and medial epicondylectomy for cubital tunnel syndrome.
MATERIALS AND METHODS
In 50 cases, we analyzed 32 cases followed more than 12 months. In 32 cases, 17 patients underwent in situ compression and 15 patients underwent medial epicondylectomy. After average follow-up period, we analyzed the operative results. The average follow-up period was 27 months(12~51 months). The results were divided into pain, sense, motor, and function using Gabel & Amadio grade (Table 1), and then estimated by 4 steps. Also, we divided into 3 grades using McGowan grade (Table 2), and then compared the score.
RESULTS
The results of in situ decompression were 3 excellent cases, 5 good cases, 7 fair cases, and 2 poor cases by Gabel & Amadio grade. The results of medial epicondylectomy were 3 excellent cases, 4 good cases, 7 fair cases, and 1 poor case by Gabel & Amadio grade. However, there was no significant difference between the in situ decompression(5.45) and medial epicondylectomy(5.78). The results of McGowan grade I were 3 excellent cases, 1 good case. According to Gabel & Amadio grade, the average score was 8.5(range, 7~9) and the results of McGowan grade II were 3 excellent cases, 5 good cases, 5 fair cases, and 1 poor case. According to Gabel & Amadio grade, the average score was 6.7(range, 3~9). Finally, the results of McGowan grade III were 3 good cases, 9 fair cases, 2 bad cases. According to Gabel & Amadio grade, the average score was 4.85(range, 2~7), which was statistically significant difference.
CONCLUSION
Statistically there was no significant difference between in situ decompression of the ulnar nerve and medial epicondylectomy for cubital tunnel syndrome. Both operative methods have short operation time, which makes it possible to exercise the joints earlier than other operations. In conclusion, we consider both methods are available for the treatment of cubital tunnel syndrome.