Endoscopic Versus Open Cubital Tunnel Release

Aldekhayel, Salah; Govshievich, Alexander; Lee, James; Tahiri, Youssef; Luc, Mario

doi:10.1177/1558944715616097

Cited by 38 publications

(16 citation statements)

References 32 publications

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“…The current study demonstrates similar effectiveness between the endoscopic and open techniques with similar outcomes, patient satisfaction and complications (2 cases of postoperative hematoma in the endoscopic group and 1 infection in the open group). These findings are similar to several systematic review [37][38][39] that demonstrated equivalent overall clinical improvement between endoscopic and open cubital tunnel release in terms of complication profiles, re-operation rates, and visual analogue scale score reduction. Current evidence lacks data to draw rigorous conclusions on objective outcome measures, return to work, and cost-benefit analyses.…”

Section: Discussionsupporting

confidence: 89%

Sonographic Follow-Up of Patients With Cubital Tunnel Syndrome Undergoing in Situ Open Neurolysis or Endoscopic Release: The SPECTRE Study

Lucchina

Fusetti

Guidi

2019

Hand (New York, N,Y.)

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Background:The measurement of cross-sectional area (CSA) is a diagnostic tool to detect entrapments syndrome. The aim of this study was to compare the clinical outcome in elbows undergoing endoscopic and “in situ” open cubital tunnel release for cubital tunnel syndrome (CuTS) using ultrasound-related changes in the largest CSA of the ulnar nerve. The purpose is to determine the association between clinical outcome and CSA. Methods: From May 2011 to April 2016, 60 patients with CuTS were prospectively followed and not randomly divided in two groups: 30 patients undergoing an endoscopic release (ER) and 30 patients with “in situ” open neurolysis (OR). A sonographic examination was performed by the senior authors at baseline and 3, 6, and 12 months after surgical decompression. Results: CSA values were statistically significantly lower in the ER. Hand grip strength difference with Jamar test was not statistically significant a 12 months (39 kg vs 27 kg). Static-2 point discrimination test difference was only statistically significant lower in the endoscopic group at 3, 6 and 12 months but not clinically relevant (5 mm vs 6 mm). The American Shoulder and Elbow Surgeons—Elbow questionnaire (ASES-e) function score, ASES-e Pain score, and ASES-e Satisfaction score were not statistically significant different between the two groups at 3, 6, and 12 months post operatively. Conclusions: The study confirms that in spite of lower values of CSA in the ER, there is not a statistically significant difference between the two techniques in terms of subjective outcomes. Ultrasound (US) measurements seem to have a limited value in clinical results of patients treated for entrapment neuropathy of the ulnar nerve. Type of study/LOE: Prognostic Level III

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Section: Discussionsupporting

confidence: 89%

Sonographic Follow-Up of Patients With Cubital Tunnel Syndrome Undergoing in Situ Open Neurolysis or Endoscopic Release: The SPECTRE Study

Lucchina

Fusetti

Guidi

2019

Hand (New York, N,Y.)

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“…A newer endoscopic approach has also been shown to offer slightly better outcomes and slightly lower rates of overall complications [3, 8]. However, a meta-analysis comparing open vs. endoscopic approach found that the endoscopic group had higher rates of post-operative hematomas and that both groups had similar reoperation rates [9].…”

Section: Discussionmentioning

confidence: 99%

Case Series: A Minimally Invasive Tunneling Approach for Cubital Tunnel Syndrome

Rashid

Tora

Long

et al. 2019

Cureus

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Background Cubital tunnel syndrome (CuTS) is the second most common peripheral neuropathy in the United States. All three current surgical treatment approaches, consisting of in situ decompression, medial epicondylectomy, and transposition, require large curvilinear incisions and dissections that cross the medial epicondyle. However, the use of a large curvilinear incision may not be necessary for in situ decompression and may be achieved with small incisions proximal and distal to the medial epicondyle. This may limit the risk of peri-incisional pain and numbness, similar to the benefits provided by endoscopy. Objective The aim of this study is to evaluate a minimally invasive tunneling approach for in situ ulnar nerve decompression utilizing 2 cm incisions proximal and distal to the medial epicondyle. Methods A retrospective chart review was performed for patients at Emory University Hospital with CuTS who underwent minimally invasive tunneling for in situ decompression. Seven cases were identified. Patient demographics and data on post-operative complications were collected. Pre-operative severity was graded as a Modified McGowan severity. The primary outcome was evaluated using the post-surgical Messina Criterion. Secondary outcomes were reports of peri-incisional pain or numbness evaluated at follow-up. Descriptive statistics are presented. Results Pre-operatively, one of the seven cases was Grade I McGowan and the remaining six were Grade 2a or 2b. Post-operatively, on the Messina Criterion, four of seven patients were rated as having “Good” outcomes, two of seven had “Fair”, while one of seven had “Poor.” There was one post-operative surgical site infection. Among the other six cases, there were no reports of peri-incisional pain or numbness. Conclusions The use of less-invasive tunneling approach to in situ decompression yielded positive outcomes in this case series with no reports of peri-incisional pain or numbness. A prospective trial may be useful to explore the theoretical benefits of this novel tunneling approach.

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“…Yet there were more overall complications associated with open decompression. 28,50 Scar tenderness and injuries to the medial antebrachial cutaneous nerve were Fok et al…”

Section: Comparative Studies and Meta-analysis Between Endoscopic Cubital Tunnel Decompression And Open Decompressionmentioning

confidence: 99%

“…associated with the open decompression while haematoma was associated with endoscopic decompression. 28,29…”

Section: Comparative Studies and Meta-analysis Between Endoscopic Cubital Tunnel Decompression And Open Decompressionmentioning

confidence: 99%

Endoscopic cubital tunnel decompression – Review of the literature

Fok

Cobb

Bain

2021

J Orthop Surg (Hong Kong)

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Cubital tunnel syndrome is the second most common compressive neuropathy of the upper limb. Endoscopic cubital tunnel decompression has gained popularity in recent years as this enables surgeons to achieve decompression of the ulnar nerve along its course using a small incision. This article describes the technical peals in performing endoscopic cubital tunnel decompression. In conditions which anterior transposition of the ulnar nerve is needed, subcutaneous transposition can be performed under endoscopic guidance. In addition, current literature is reviewed, and outcomes are presented. While short term results are encouraging, further prospective randomized study with longer follow-up is recommended.

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Endoscopic Versus Open Cubital Tunnel Release

Cited by 38 publications

References 32 publications

Sonographic Follow-Up of Patients With Cubital Tunnel Syndrome Undergoing in Situ Open Neurolysis or Endoscopic Release: The SPECTRE Study

Sonographic Follow-Up of Patients With Cubital Tunnel Syndrome Undergoing in Situ Open Neurolysis or Endoscopic Release: The SPECTRE Study

Case Series: A Minimally Invasive Tunneling Approach for Cubital Tunnel Syndrome

Endoscopic cubital tunnel decompression – Review of the literature

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