Decompression can Effectively Treat Cubital Tunnel Syndrome

Ulnar nerve decompression, anterior subcutaneous transpositions and anterior submuscular transpositions are equally effective in the treatment of cubital tunnel syndrome, according to results of a recent study.

“Choosing a surgical treatment has been as much a matter of personal choice as it has been based on scientific knowledge. As seen in previously published data, most comparative studies demonstrate equivalent results in outcomes with any particular technique. Taking this into account, we should chose the simplest technique to treat these patients,” André Sá Rodrigues, M.D., said.

In the retrospective study, the researchers collected data of patients diagnosed with idiopathic cubital tunnel syndrome who had surgery between January 2005 and December 2010. Overall, 34 patients underwent surgical treatment, with eight patients having ulnar nerve decompression, 18 patients having anterior subcutaneous transpositions and eight patients having anterior submuscular transpositions. Average age was 48 years and 56 percent of the patients were female. In 53 percent of cases, the affected side was the left, the right side for 41 percent of patients and 6 percent of the patients had bilateral cubital tunnel syndrome. The dominant limb was affected for 45 percent of patients. Minimum follow-up was one year.

Postoperative results were excellent in 66.7 percent of patients, good for 16.7 percent of patients, fair in 10 percent of patients and poor for 6.7 percent of patients. Researchers concluded no significant differences between the three groups. The results were excellent or good in 62.5 percent of patients treated with anterior submuscular transposition, in 85.7 percent of patients treated with anterior subcutaneous transposition, and in all the patients treated with ulnar nerve decompression. However, they found decompression of the ulnar nerve was less harmful and better preserved blood flow. In most cases, the simpler surgical decompression of the cubital tunnel is adequate, he said.

Rodrigues said obesity negatively influenced the postoperative results of cubital tunnel syndrome. Disease severity, age, gender, lesion side and dominant side did not change the effectiveness of the surgical treatment.