Endoscopic cubital tunnel decompression – Review of the literature

Fok, Matthew; Cobb, Tyson K.; Bain, Gregory I.

doi:10.1177/2309499020982084

Cited by 7 publications

(4 citation statements)

References 52 publications

(113 reference statements)

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“…This highlights the minimally invasive character of the URUN, implying less scarring of soft tissue and better aesthetics, and suggests the possibility of reduced pain and faster recovery in live subjects [22]. It is worth mentioning that incision length in URUN was even smaller than that of the endoscopic techniques (15-30 mm) [23][24][25][26], or the mini-open release (1.5-2.5 cm) [27], potentially making the URUN the least invasive procedure to date.…”

Section: Discussionmentioning

confidence: 87%

Percutaneous ultrasound-guided ulnar nerve release technique compared to open technique: A cadaveric study

Mansour

Ghanimeh

Ghersi

et al. 2022

SICOT-J

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Objectives: To evaluate the outcomes of a novel percutaneous ultrasound-guided technique for release of ulnar nerve entrapment at the elbow when compared to standard open release Methods: One single surgeon performed an ultrasound-guided percutaneous release of the cubital tunnel on a group of five cadaveric elbows and open release on five others. All procedures were timed, and incision lengths were recorded. Meticulous anatomic dissection was then performed to assess the complete release of the carpal tunnel and iatrogenic injuries. Results: No significant difference was found between the two groups in terms of complete release and iatrogenic injury, whereas Operative time was significantly shorter for the US-guided technique. Incomplete releases of the nerve were found only during the first two trials in each group, while the third, fourth, and fifth trials showed a complete ulnar nerve release in both series, highlighting a fast learning curve for both techniques. All of this through a significantly smaller incision in the US-guided technique. Conclusions: This study highlights the similar effects of these two techniques in terms of complete release of the ulnar nerve, with no clear superiority of one over the other in terms of morbidity rate. Both have a fast learning curve for an ultrasound-trained surgeon, with the US-guided technique being a less traumatic and quicker alternative procedure.

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Section: Discussionmentioning

confidence: 87%

Percutaneous ultrasound-guided ulnar nerve release technique compared to open technique: A cadaveric study

Mansour

Ghanimeh

Ghersi

et al. 2022

SICOT-J

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“…Some authors consider medial epicondylectomy to be less risky than transposition, but complications have been reported [ 123 , 138 ]. Endoscopic nerve decompression is used but usually involves extensive neurolysis distally, which can be questioned [ 132 , 139 , 140 , 141 ]. Other techniques, like brief electrical stimulation, have also been reported as favorable as an adjunct to surgery [ 142 ].…”

Section: Treatmentmentioning

confidence: 99%

The Unpredictable Ulnar Nerve—Ulnar Nerve Entrapment from Anatomical, Pathophysiological, and Biopsychosocial Aspects

Nyman,

Dahlin

2024

Diagnostics

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Peripheral nerves consist of delicate structures, including a rich microvascular system, that protect and nourish axons and associated Schwann cells. Nerves are sensitive to internal and external trauma, such as compression and stretching. Ulnar nerve entrapment, the second most prevalent nerve entrapment disorder after carpal tunnel syndrome, appears frequently at the elbow. Although often idiopathic, known risk factors, including obesity, smoking, diabetes, and vibration exposure, occur. It exists in all adult ages (mean age 40–50 years), but seldom affects individuals in their adolescence or younger. The patient population is heterogeneous with great co-morbidity, including other nerve entrapment disorders. Typical early symptoms are paresthesia and numbness in the ulnar fingers, followed by decreased sensory function and muscle weakness. Pre- and postoperative neuropathic pain is relatively common, independent of other symptom severity, with a risk for serious consequences. A multimodal treatment strategy is necessary. Mild to moderate symptoms are usually treated conservatively, while surgery is an option when conservative treatment fails or in severe cases. The decision to perform surgery might be difficult, and the outcome is unpredictable with the risk of complications. There is no consensus on the choice of surgical method, but simple decompression is relatively effective with a lower complication rate than transposition.

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“…Several techniques for the surgical treatment of cubital tunnel syndrome have been previously described. [1][2][3] In situ cubital tunnel release, without anterior transposition of the ulnar nerve, has become increasingly common amongst surgeons with evidence of equal efficacy and lower complication rates. [3][4][5][6][7][8] In addition to providing equal efficacy with fewer complications, in situ cubital tunnel release also confers flexibility to both patients and surgeons since it can be performed in open and minimally invasive (endoscopic) manners.…”

Section: Introductionmentioning

confidence: 99%

“…Ulnar nerve compression within the cubital tunnel (cubital tunnel syndrome) is a commonly encountered upper extremity compressive neuropathy that frequently prompts patients to seek surgical treatment in an effort to prevent and/or minimize its potentially serious long term effects of numbness, weakness, intrinsic atrophy, and digital contractures. Several techniques for the surgical treatment of cubital tunnel syndrome have been previously described 1–3 . In situ cubital tunnel release, without anterior transposition of the ulnar nerve, has become increasingly common amongst surgeons with evidence of equal efficacy and lower complication rates 3–8 .…”

Section: Introductionmentioning

confidence: 99%

WALANT office based endoscopic cubital tunnel release

Hoelscher,

Pientka

2024

Current Orthopaedic Practice

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Background: Cubital tunnel syndrome is a common condition caused by compression of the ulnar nerve around the medial elbow. Surgical treatment usually involves open in situ ulnar nerve decompression unless ulnar nerve instability is noted. Endoscopic techniques for cubital tunnel release have been developed and implemented with excellent patient and surgeon satisfaction. Endoscopic cubital tunnel release can be performed in an office based procedure room under wide awake local anesthesia no tourniquet principles. We present our setup and technique for performing an endoscopic cubital tunnel release procedure in an office based setting under local anesthesia. Methods: Local anesthesia is injected along the course of the ulnar nerve on the medial arm and forearm extending 10 cm proximal and distal to the medial epicondyle. After allowing approximately 30 min for appropriate vasoconstriction, the patient is placed in a supine position with the arm abducted and externally rotated position. The endoscopic cubital tunnel release is then performed. Discussion: Our described technique eliminates the need for placement of a prophylactic tourniquet and thereby the need for the procedure to be performed within an OR setting. It also utilizes a single-stage anesthetic administration, which facilitates ease of completion and performance in an office based setting. There is a significant cost savings when endoscopic cubital tunnel release is performed in an office-based procedure room compared to in the operating room. Conclusions: Office-based endoscopic cubital tunnel release can be safely performed utilizing WALANT techniques, leading to high patient satisfaction and decreased overall cost of care. Level of Evidence: Therapeutic IV

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Endoscopic cubital tunnel decompression – Review of the literature

Cited by 7 publications

References 52 publications

Percutaneous ultrasound-guided ulnar nerve release technique compared to open technique: A cadaveric study

Percutaneous ultrasound-guided ulnar nerve release technique compared to open technique: A cadaveric study

The Unpredictable Ulnar Nerve—Ulnar Nerve Entrapment from Anatomical, Pathophysiological, and Biopsychosocial Aspects

WALANT office based endoscopic cubital tunnel release

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