Incidence of Re-operation and Subjective Outcome Following In Situ Decompression of the Ulnar Nerve at the Cubital Tunnel

Author(s): Goldfarb CA, Sutter MM, Martens EJ, Manske PR

Source: J Hand Surg 34E:379-383, 2009.

Summary:

The authors preformed a retrospective review of 56 adult patients who had undergone in situ decompression for cubital tunnel syndrome in 69 extremities.  After decompression, symptoms were improved substantially or resolved.  At a minimum of 1-year after surgery, 5 limbs (7%) with persistent symptoms were treated successfully with anterior submuscular transposition.

The findings from this study suggest that in situ decompression of the ulnar nerve is a reliable treatment for cubital tunnel syndrome and has a low failure rate.  Previous studies have shown minimal or no significant differences between various surgical techniques (e.g., in situ decompression, anterior subcutaneous nerve transposition, and anterior submuscular transposition).  The advantages of in situ decompression include a shorter incision with less surgical dissection, avoidance of ulnar nerve devascularization, and faster rehabilitation and recovery.  The uncommon patient with continued symptoms after in situ decompression may be effectively treated with transposition of the ulnar nerve.