Comparative Study of Outcome of Simple Decompression Versus Anterior Transposition of Ulnar Nerve in the Treatment of Cubital Tunnel Syndrome

Abstract

Background: Cubital tunnel syndrome (CuTS) is the second most common entrapment neuropathy in the upper limb, after the entrapment of the median nerve in the carpal tunnel. Different techniques of nerve decompression have been described, however, the idyllic surgical treatment and technique for CuTS remain controversial.Objective: Our aim is to compare the outcome of simple decompression with anterior subcutaneous transposition of ulnar nerve in the treatment of CuTS. Methods:The study included 20 patients that were surgically treated in the Neurosurgery department at Gamal Abdel Nasser Hospital -General Authority for Health Insurance between August 2014 and February 2015. These patients were randomly distributed into two equal groups, each consisting of 10 cases. In the first group, only simple decompression was performed while in the second group, anterior subcutaneous transposition was supplemented. All cases were followed for at least 6 months.Results: Seventy percent of the patients were females and the mean age was 45.35 ± 14.62. The duration of symptoms before surgery varied from 4 months to 2 years. Occupational repetitive elbow flexion and extension was the most common contributing factor. Seven out of ten patients, in the simple decompression group, showed clinical and electrophysiological improvement at 6 months interval. While in the second group, only six patients showed improvement 6 months after surgery. The difference was found to be statistically insignificant. There was no significant effect of the duration of symptoms or co-morbidities on the outcome. Conclusion:Long term follow up revealed no significant difference between simple decompression and anterior subcutaneous transposition. Simple decompression of the ulnar nerve, in our experience, is an effective and less invasive technique for patients with cubital tunnel syndrome.