Clinical application of endoscopic decompression and anterior transposition of ulnar nerve in CO_2 generated cavity

Objective To introduce the method of endoscopic decompression and anterior transposition of the ulnar nerve in carbon dioxide generated cavity for treatment cubital tunnel syndrome,Methods The operations were performed in 9 elbows of 8 cubital tunnd syndrome cases,According to Dellon's criteria, three elbows were categorized preoperatively as gradeⅠ, four as gradeⅡ, and two elbows of one case as gradeⅢ. Along the course of ulnar nerve in the upper arm a 1.0-1.5 cm transverse incision was made 10 cm above elbow for endoscope approach,Another 0.5-1.0 cm transverse incision was made lateral to the ulnar nerve or posteromedial to the elbow for operation approach,CO_2 was pumped using laparescopic system to generate a space for maneuvering,The ulnar nerve was released and transposed anteriorly in the cavity which was maintained with CO_2 inflation,Results All of the 8 cases were operated successfully,The average operation time was 45 to 60 minutes,No ulnar nerve injury was found under the endoscope,There was no subcutaneous pneumatosis and hematoma,The patients were followed for 8 to 15 months,All patients had improvement of their symptoms,No subluxation of the ulnar nerve was noted,Clinical results were evaluated as excellent for 5 cases and good for 4. Condusion Endoscopic decompression and anterior transposition of the ulnar nerve in CO_2 generated cavity is as effective as traditional open operation,It has the advantage of being less invasive and more aesthetic.