Cubital tunnel syndrome - SECEC 2014

Benefits of endoscopiy for transposition in cubital tunnel syndrome : a prospective study about 16 cases

P.Croutzet, J.Kany, R. Guinand
Société Européenne pour la Chirurgie de l'Epaule et du Coude – Istanbul, Septembre 2014

 

Introduction

Endoscopic release for cubital tunnel syndrom is demonstrated as en efficient procedure. However, endoscopy finds limits when transposition is needed.

Goal

This prospective case series aims at demonstrating benefits of endoscopy for transposition in cubital tunnel syndromep>

Method

Over a one-year-period, 16 patients were operated for an endoscopic release and transposition.
Inclusion criteria were :
- isolated ulnar compression at the elbow without clinical sensitive and motor deficit 
- indication of transposition : nerve instability or bone deformity of the elbow (arthritis, cubitus valgus >15°).

We used a 2,5cm incision, a 4mm endoscope, an Eaton aponeurosis flap for anterior stabilization, neither cast nor physiotherapy.

Physical examination was performed after 1 and 3 months. Analysis criteria were: - peroperative : incision length, duration of surgery - postoperative : pain, paresthesias, elbow motion, time off work.

Results

Surgical time went down from 45 to 25 minutes; incision length was between 2 to 3,5cm. All patients had pain after 1 month with very little daily activity impairment, none patient had pain after 3 months. Paresthesias decrease in all cases after 1 month and disappeared in 15/16 after 3 months. Motion of the elbow was full after 1 month, time off work was 3 weeks (0-8). None deficit of the medial cutaneous nerve of forearm was noticed

Conclusion

Endoscopic transposition is a reliable and efficient procedure that leads to quick recovery. Endoscopy is reliable either for simple release or transposition. In the future, this procedure could easily be used to perform postero-medial portals in elbow-arthroscopy.

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