Cubital Tunnel Syndrome: Current Concepts

Staples, Jonathan Robert; Calfee, Ryan P.

doi:10.5435/jaaos-d-15-00261

Cited by 104 publications

(108 citation statements)

References 48 publications

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“…The compression of the ulnar nerve at the elbow, defined as cubital tunnel syndrome [68], is another musculoskeletal complication described in acromegaly [67], and, similar to carpal tunnel syndrome, the pathogenesis seems to be the significantly larger area of the ulnar nerve in ACRO [64,67].…”

Section: Musculoskeletal Complicationsmentioning

confidence: 99%

Acromegaly and ultrasound: how, when and why?

Parolin

Dassiè

Vettor

et al. 2019

J Endocrinol Invest

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Background Acromegaly is a rare disease caused by an excess of growth hormone and insulin-like growth factor 1. It is usually diagnosed because of typical signs such as macroglossia, acral enlargement, jaw prognathism and malocclusion. Systemic complications are a major cause of morbidity and mortality in acromegaly, and many patients remain undiagnosed for several years. Increased ultrasound (US) application in the general population, and including among acromegaly patients, has revealed many suggestive features which, taken together with clinical suspicion, could induce suspicion of this disease. Purpose This review describes main US features in acromegaly. Echocardiography shows a typical cardiomyopathy, characterized by left ventricular hypertrophy, diastolic and systolic dysfunction, aortic and mitral regurgitation, and increased aortic root diameters. US preclinical markers of atherosclerosis, such as intima media thickness (IMT), seem also to be impaired. Visceromegaly and increased organ stiffness are other features of acromegaly, including enlarged prostate, kidneys, liver, and thyroid. In addition, other US findings are: renal cysts, micronephrolithiasis, impairment of renal haemodynamic parameters, gallstones and gallbladder polyps, hepatic steatosis, thyroid nodules, multinodular goiter, and polycystic ovaries. Musculoskeletal US findings are increased cartilage thickness, impaired density and elasticity of bones, nerve enlargement, carpal and cubital tunnel syndrome, and trigger finger. Conclusions Acromegaly patients frequently present systemic complications and a diagnostic delay. US features of acromegaly are not specific, but could potentially have a key role in early detection of the disease in the presence of typical clinical features.

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Section: Musculoskeletal Complicationsmentioning

confidence: 99%

Acromegaly and ultrasound: how, when and why?

Parolin

Dassiè

Vettor

et al. 2019

J Endocrinol Invest

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“…The mean reported rate of post‐traumatic ulnar neuritis was 12.3% (range 0–50.9%) of temporary injury and 5.4% (range 0–15%) of permanent injury . Symptoms may occur during initial injury or after surgery due to swelling, scarring and thickening of the cubital tunnel . Mild and possibly moderate ulnar neuritis could recover gradually after non‐surgical intervention such as splints and drugs .…”

Section: Discussionmentioning

confidence: 99%

Combined use of Kirschner wires and hinged external fixator for capitellar and trochlear fractures: a minimum 24‐month follow‐up

Zhao

Guo

et al. 2018

ANZ Journal of Surgery

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Background: Open reduction and internal fixation is the adequate treatment for capitellar and trochlear fractures. Given the low incidence of this type of fractures, it is difficult to constitute a universally accepted method for fixation. Thus, we hypothesised that combined use of Kirschner wires (K-wires), absorbable rods and sutures for fixation and post-operative hinged external fixator for early rehabilitation exercise can restore elbow joint function well. Methods: This retrospective study included 20 patients with a mean age of 48.3 (range 16-76) years. According to the Dubberley classification, fractures were classified on plain radiographs, computed tomography images and intra-operative findings. All patients were evaluated by the range of motion of the elbow and the Broberg-Morrey score. Results: All fractures had healed without non-union, and the average time was 13.6 (range 8-17) weeks. The mean follow-up was 42.5 (range 24-80) months. The mean flexion was 117.1 (range 90 -135 ), and the mean extension was 17.5 (range 0 -45 ). The mean pronation was 74.4 (range 45 -85 ), and the mean supination was 84.3 (range 60 -90 ). The average Broberg-Morrey score was 86.2 (range 68-98) points with 10 excellent, 7 good and 3 fair results. Conclusion: K-wires, absorbable rods and sutures combined with hinged external fixator are feasible for fixation of capitellar and trochlear fractures. However, due to the absence of a control group (such as Herbert screw fixation), comparative studies are still needed to demonstrate the safety and reliability of K-wires for fixation.

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“…Ulnar nerve entrapment at the elbow, generally defined as cubital tunnel syndrome, represents the second most common compression neuropathy of the upper extremity. [ 1 2 3 ] Etiology varies from either static factors due to bony and soft-tissue disorders (including osteoarthritis, cubitus valgus, ganglion, tumor, facial strictures, or accessory muscle) or dynamic components, such as minor repetitive injury secondary to increasing pressure within the cubital canal during elbow flexion or subluxation of the ulnar nerve. [ 2 4 5 6 ]…”

Section: Introductionmentioning

confidence: 99%

“…Presenting symptoms range from numbness and tingling in the ulnar nerve distribution, often accompanied by weakness of the grip, to clawed fingers and occasionally severe intrinsic wasting. [ 3 ] If adequate conservative nonsurgical treatment fails to relieve progressive symptoms and dysfunction, surgical decompression is indicated, typically involving either superficial approaches ( in situ decompression and anterior subcutaneous transposition) or deep approaches (medial epicondylectomy or anterior sub- or intramuscular transposition). [ 7 8 9 10 11 12 13 ]…”

Section: Introductionmentioning

confidence: 99%

Anterior Subcutaneous Transposition of the Ulnar Nerve Affects Elbow Range of Motion

Liu

Gong

Wang

et al. 2018

Chinese Medical Journal

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Background:Surgical decompression of the ulnar nerve is effective for cubital tunnel syndrome. However, deep approaches may result in iatrogenic elbow stiffness. This long-term study was to evaluate the range of motion (ROM) of the elbow and functional outcomes after anterior subcutaneous transposition.Methods:A total of 115 patients (78 male and 37 female; mean age: 46.6 years) who underwent anterior subcutaneous transposition of the ulnar nerve between 2001 and 2005 were evaluated retrospectively; mean follow-up was 13.5 years. Elbow ROM was measured as flexion arc, flexion, and extension preoperatively and at the final follow-up, and compared via a mixed analysis of variance adjusting for age. Neuropathy was assessed preoperatively using a modified McGowan neuropathy grade and postoperatively using modified Wilson–Krout criteria. An ordinal logistic regression analysis used postoperative modified Wilson–Krout criteria as the outcome and preoperative factors as predictors.Results:Preoperative McGowan grades were Grade 1 in 14 patients (12.2%), Grade 2A in 28 (24.3%), Grade 2B in 53 (46.1%), and Grade 3 in 20 (17.4%) patients. Postoperatively, 66 patients (57.4%) had excellent results, 26 (22.6%) had good results, 16 (13.9%) had fair results, and 7 (6.1%) had poor results at the final follow-up, as per the Wilson–Krout criteria. There were no complications. Pre- and postoperative elbow ROM was significantly decreased in patients with previous trauma or surgery of the elbow compared with those without (P < 0.05). Anterior subcutaneous transposition of the ulnar nerve did not significantly affect elbow ROM regardless of previous trauma or surgical history nor preoperative ROM (P > 0.05), after adjusting for age. Patients with prolonged symptoms prior to surgery and worse neuropathy tended to have less satisfactory functional outcomes (P < 0.05), after adjusting for covariates.Conclusions:Anterior subcutaneous transposition of the ulnar nerve is an effective and reliable treatment of cubital tunnel syndrome with satisfactory outcomes and minimal effect on elbow ROM.

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Cubital Tunnel Syndrome: Current Concepts

Cited by 104 publications

References 48 publications

Acromegaly and ultrasound: how, when and why?

Acromegaly and ultrasound: how, when and why?

Combined use of Kirschner wires and hinged external fixator for capitellar and trochlear fractures: a minimum 24‐month follow‐up

Anterior Subcutaneous Transposition of the Ulnar Nerve Affects Elbow Range of Motion

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