Minimally Invasive Ulnar Nerve Decompression for Cubital Tunnel Syndrome

Objective: The purpose of this study is to present the efficacy of the surgical technique using a minimal skin incision for the treatment of cubital tunnel syndrome. Ulnar nerve entrapment at the elbow is the second most common compression neuropathy of the upper extremity. Surgical treatment of conventional simple decompression of ulnar nerve is considered to be relatively safe and reliable. However, this surgical technique is needed a relatively long incision and often can result in significant postoperative scarring and delay in return to work. Methods: Ten patients with cubital tunnel syndrome underwent simple decompression using a 2 cm or less skin incision. According to Dellon’s criteria, one elbow was classified as grade 1, four as grade 2, and five as grade 3. Preoperative electrodiagnostic studies were performed on all patients and 6 of them were rechecked postoperatively. Results: Preoperative motor conduction velocity (MCV) within the segment was 35.5±16.2 m/s and decreased than the result of MCV in the below the elbow-wrist segment (59.3±5.9 m/s, p< 0.05). Postoperative results of MCV were improved in all patients from 37.1±13.2 m/s to 51.9±8.9 m/s (p<0.05). After an average follow-up of 5.9±5.0 months, all patients were reported to be in good or excellent condition. Conclusion: We could observe an enough distance of the ulnar nerve from proximal to distal area without difficulty using manual retraction. Simple decompression through a small skin incision can be recommended for the treatment of cubital tunnel syndrome, if the indication is appropriate. (J Kor Neurotraumatol Soc 2009;5:16-21)