Visualization During Endoscopic Versus Open Cubital Tunnel Decompression: A Cadaveric Study

Said, Joseph; Frizzell, Kaela; Heimur, Juliana; Kachooei, Amir Reza; Beredjiklian, Pedro K.; Rivlin, Michael

doi:10.1016/j.jhsa.2018.10.004

Cited by 12 publications

(8 citation statements)

References 21 publications

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“…17 Under endoscopic guidance, ulnar nerve can be released from the Arcade of Struthers proximally to the heads of FCU muscles distally. With early results showing satisfactory outcomes, minimal complications and small incision (ie, smaller than open decompression in situ [18][19][20][21][22][23][24][25] ), endoscopic cubital tunnel has gained popularity in recent years. 5 Different instruments dedicated for cubital tunnel release have been introduced into the market.…”

Section: State Of the Art Reviewmentioning

confidence: 99%

“…34 A prospective study by Bolster et al 19 comparing techniques of endoscopic cubital tunnel decompression and open decompression in situ, showed that the incision of endoscopic decompression was similar to open technique (ie, 3 mm; 2.4 cm vs 2.7 cm, respectively). However, a cadaveric study comparing open and endoscopic techniques 18 revealed that a 4 cm open incision was equivalent to a 2 cm endoscopic incision, in allowing the visualisation of approximately 9 cm proximal and 9 cm distal to the medial epicondyle. The tourniquet time for open decompression in situ was significantly shorter by an average of 7 min when compared with the endoscopic technique.…”

Section: Current Literature On Outcomesmentioning

confidence: 99%

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Endoscopic cubital tunnel decompression: state of the art

2021

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Section: State Of the Art Reviewmentioning

confidence: 99%

Section: Current Literature On Outcomesmentioning

confidence: 99%

Endoscopic cubital tunnel decompression: state of the art

2021

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“…The cadaveric studies show that the compressive structures spanning from an average of 8.2 cm. proximal to 6.4 cm distal from the medial epicondyle [7], Josep Said et al stated that a 4-cm open incision is needed to allow the visualization of 9 cm [8]. There are many studies that support that endoscopic cubital tunnel decompression has a smaller incision, greater field of view, better short-term outcome, and fewer complications [9].…”

Section: Introductionmentioning

confidence: 99%

Cost-saving Minimal Incision Endoscopic-assisted Cubital Tunnel Release Using Simple Surgical Instruments: Case Series

Jaroenporn

Predeeprompan

Vechasilp

et al. 2019

Cureus

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Cubital tunnel syndrome (CuTS) is a well-recognized compressive neuropathy worldwide. With technological advancement, endoscopy is introduced to facilitate the procedure. However, there are concerns about the excessive cost that comes with special instruments. This article aims to provide the results of the cost-saving endoscopic-assisted cubital tunnel release surgical technique that uses the normally available operating instruments.A retrospective review was performed of the nine patients that were diagnosed with CuTS and underwent minimal incision endoscopic-assisted cubital tunnel release in Police General Hospital. Patients were followed up to sixth month postoperation. The modified McGowan classification was used to determine the severity of symptoms. Surgical outcomes were evaluated by the modified Bishop classification, visual analog score (VAS), and patients' satisfaction. Other factors investigated were scar pain and peri-incisional numbness and hematomas.The incisions were measured as 7-9 mm. All patients reported having a pain score of 1 on the third day. Seven of nine patients were able to return to work one day after surgery. Modified Bishop score showed five excellence, three good, and one fair after two weeks. There was no surgical-related complication found. All patients noted the excellence satisfaction of the procedure.The minimal incision endoscopic-assisted cubital tunnel release has shown favorable outcomes with the cost-saving of simple instruments. However, a large prospective trial may be needed for further study.

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“…In situ release of the cubital tunnel can be performed using open, mini-open, extensile open, and endoscopic techniques. 1 Endoscopic cubital tunnel release (ECuTR) allows for enhanced visualization 2 and has shown comparable results in decompressing the ulnar nerve and improving symptoms. 3 , 4 , 5 Endoscopic cubital tunnel release also offers minimally invasive benefits because it allows the surgeon to minimize extensive dissection, ulnar nerve devascularization, and manipulation.…”

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confidence: 99%

Classification and Treatment of Ulnar Nerve Subluxation Following Endoscopic Cubital Tunnel Release

Mirza¹,

Mirza²,

Thomas³

2020

Journal of Hand Surgery Global Online

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Classification Cubital tunnel syndrome Elbow Endoscopic cubital tunnel release Minimally invasive Purpose: Endoscopic cubital tunnel release (ECuTR) is an effective procedure to alleviate cubital tunnel syndrome. To improve patient outcomes and lessen concerns regarding ulnar nerve subluxation (UNS) after ECuTR, the current study proposes an intraoperative UNS classification system and subsequent treatment protocol. We present a preliminary report of patients treated under these guidelines. Methods: We retrospectively reviewed 87 patients (100 ECuTRs). Nerve mobility was classified during surgery, in which grade 1 ¼ no movement or partial subluxation; deep retrocondylar groove and/or no generalized hypermobility (no further intervention); grade 2 ¼ partial subluxation; shallow retrocondylar groove and/or inherent generalized hypermobility (required medial epicondylectomy); and grade 3 ¼ complete anterior dislocation (required medial epicondylectomy or anterior transposition). Clinical outcomes at final follow-up (mean ± SD, 34 ± 20.3 weeks; range, 5e89 weeks) were collected and included Disabilities of the Arm, Shoulder, and Hand questionnaires, visual analog scale pain score, grip and pinch strength, 2-point discrimination, and range of motion. Results: We report 37 patients (42 cases), grade 1 (n ¼ 30), grade 2 (n ¼ 1), and grade 3 (n ¼ 11). Gross grip strength, lateral, 3-jaw chuck, and precision pinch strength recovered 87%, 90%, 105%, and 87%, respectively. Wrist and elbow range of motion returned to normal limits, 2-point discrimination improved to normal scores at final follow-up, Disabilities of the Arm, Shoulder, and Hand scores were reduced from 59.8 before to 29.9 after surgery, and visual analog scale pain score improved from 7.2 before to 2.5 after surgery (P < .001). Conclusions: To our knowledge, this is the first study to classify UNS after ECuTR and describe a guideline for ensuing treatment. Our preliminary report of patients shows satisfactory outcomes, which suggests that our intraoperative UNS classification system has promise in preventing adverse complications of ulnar nerve hypermobility after ECuTR. Type of study/level of evidence: Therapeutic IV.

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Visualization During Endoscopic Versus Open Cubital Tunnel Decompression: A Cadaveric Study

Cited by 12 publications

References 21 publications

Endoscopic cubital tunnel decompression: state of the art

Endoscopic cubital tunnel decompression: state of the art

Cost-saving Minimal Incision Endoscopic-assisted Cubital Tunnel Release Using Simple Surgical Instruments: Case Series

Classification and Treatment of Ulnar Nerve Subluxation Following Endoscopic Cubital Tunnel Release

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