Endoscopic neurolysis of the ulnar nerve: retrospective evaluation of the first 60 cases

• Published in: Journal of shoulder and elbow surgery 2017-06, Vol.26 (6), p.1037-1043
• Main Authors: Sautier, Etienne, MD, Neri, Thomas, MD, Gresta, Giorgio, MD, PhD, Philippot, Remi, MD, PhD, Farizon, Frederic, MD
• Format: Article
• Language: English
• Subjects: Case-Control Studies; compression neuropathy; cubital tunnel syndrome; Cubital Tunnel Syndrome - physiopathology; Cubital Tunnel Syndrome - surgery; Decompression, Surgical - methods; Electromyography; endoscopic neurolysis; Endoscopy - methods; entrapment; Female; Humans; Life Sciences; Male; Middle Aged; minimally invasive surgery; nerve release; Neurosurgical Procedures - methods; Orthopedics; Retrospective Studies; Treatment Outcome; Ulnar nerve; Ulnar Nerve - physiopathology; Ulnar Nerve - surgery
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2016.11.042

Background The aim of this study was to determine the clinical efficacy of minimally invasive endoscopic ulnar nerve release at midterm follow-up. Methods This was a retrospective, consecutive, single-center study. The inclusion criterion was presentation of the patient with isolated and stable cubital tunnel syndrome. The surgical technique described by Hoffmann and Siemionow in 2006 was used for all patients. The cubital tunnel syndrome was graded by Dellon's classification and scored as described by MacDermid and Grewal in 2013. Results Sixty patients underwent surgery (62 cubital tunnel operations). Fifty-three patients were included in the study. The mean follow-up was 17 months (6-34). In the preoperative period, according to Dellon's classification, 8 patients were grade 1, 29 patients were grade 2, and 16 patients were grade 3. After surgery, according to the MacDermid score, 45 patients (84.9%) had good or excellent results, 6 (11.3%) had moderate results, and 2 (3.8%) had poor results. The mean preoperative score was 103.1 (25-181), and the mean postoperative score was 26.3 (0-135). By comparison with standard surgical technique, the endoscopic technique appears to be reliable with a similar success rate and functional improvement. The advantages are the minimally invasive portion of the surgical technique. Endoscopic control allowed complete release of the ulnar nerve with few complications. Conclusion The endoscopic technique as described by Hoffman et al had similar efficacy to open surgical techniques with the advantage of being minimally invasive.