The authors report their results of endoscopic ulnar nerve decompression at the elbow in 75 patients (76 cases). They were able to release the ulnar nerve over a distance of approximately 17 cm through an incision averaging 2.8 cm in length. The mean follow-up interval was 11 months (range, 1-34 months). Using the modified Bishop Rating System, the authors found good to excellent results in 94% of patients. The authors also reported their observations from dissecting 12 cadaver arms. They found 3 distinct fascial bands covering the ulnar nerve in the proximal forearm. The bands extended from 3 to 9 cm distal to the midpoint of the retrocondylar groove and all three bands could be released endoscopically.
In situ decompression versus decompression with transposition of the ulnar nerve at the elbow remains a controversial topic. The authors of this study provide supporting data for in situ cubital tunnel decompression using an endoscopic technique. The risks of this approach must be weighed against the morbidity of a medial elbow incision used in more conventional open surgery. More compelling data to support or detract from this technique will necessitate a comparative, prospective, and randomized study design.
Cubital, Tunnel, Endoscopic, Release
Journal of Hand Surgery