Scientific articlePatient-Rated Outcome of Ulnar Nerve Decompression: A Comparison of Endoscopic and Open In Situ Decompression
Section snippets
Materials and Methods
With local ethics committee approval, data were collected on all consenting patients having ulnar nerve surgery either as an endoscopic or open procedure under the care of a single surgeon between May 1997 and March 2006. The diagnosis of ulnar nerve entrapment at the elbow was made based on a history including paresthesia or numbness in the ulnar nerve distribution, weakness or wasting of the small muscles of the hand, and a positive elbow flexion provocation test. Nerve conduction studies
Results of subjective assessment
A greater proportion of patients in the endoscopic group (15 of 19; 79%) reported that they were satisfied with the outcome of the procedure at 12 months than that in the open in situ decompression group (9 of 15; 60%) but the difference was not statistically significant (p = .229) (Table 3).
The degree of self-reported patient satisfaction measured on a VAS was a median of 90 for the endoscopic decompression group and 60 for the open in situ group. The difference between the scores for the
Discussion
The optimal treatment for cubital tunnel syndrome is widely debated. Some authors argue that the primary problem is nerve compression by overlying structures11 and that the syndrome is best treated by decompression of the nerve without removing it from its bed, therefore causing minimal disruption to the vascular supply. Others argue in favor of ulnar nerve transposition or medial epicondylectomy,12, 13, 14 citing evidence that the nerve is under tension with elbow flexion15 that can only be
References (29)
- et al.
Simple decompression versus anterior subcutaneous and submuscular transposition of the ulnar nerve for cubital tunnel syndrome: a meta-analysis
J Hand Surg
(2008) - et al.
Endoscopic release of the ulnar nerve at the elbow using the Agee device: a cadaveric study
Arthroscopy
(2005) - et al.
Endoscopic decompression of the ulnar nerve at the elbow
J Hand Surg
(2007) - et al.
The endoscopic management of cubital tunnel syndrome
J Hand Surg
(2006) - et al.
A new operative technique: cubital tunnel decompression with endoscopic assistance
Hand Clin
(1995) - et al.
The relationship between the pressure adjacent to the ulnar nerve and the disease causing cubital tunnel syndrome
J Shoulder Elbow Surg
(2008) - et al.
Treatment of cubital tunnel syndrome by frontal partial medial epicondylectomyA retrospective series of 55 cases
J Hand Surg
(2004) - et al.
Medial epicondylectomy
Hand Clin
(2007) - et al.
Cubital tunnel syndrome: a retrospective review of 53 anterior subcutaneous transpositions
J Hand Surg
(2000) - et al.
Transposition of the ulnar nerve and its vascular bundle for the entrapment syndrome at the elbow
J Hand Surg
(1995)
Anterior submuscular transposition of the ulnar nerve for cubital tunnel syndrome
J Hand Surg
Anterior intramuscular transposition of the ulnar nerve for cubital tunnel syndrome
J Shoulder Elbow Surg
The surgical treatment of cubital tunnel syndrome: a decision analysis
J Hand Surg
Simple decompression with small skin incision for cubital tunnel syndrome
J Hand Surg
Cited by (0)
The authors would like to acknowledge the important contribution made to this study by Ron Heptinstall, Enid Buckton, and Rob Maurmo.
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.