Release of ulnar nerve compression at the elbow through a transverse incision

Minimally Invasive In Situ Cubital Tunnel Decompression

The purpose of this study is to describe a modified technique for a minimally invasive approach to in situ ulnar nerve decompression and to provide long-term follow-up. Thirty-one patients were included. DASH and MHQ scores were measured. Mean postoperative DASH score was 10. Eighty percent of patients achieved a postoperative DASH score under 10. Average postoperative MHQ scores were as follows: overall hand function 89, activities of daily living 93, work 92, pain 7, esthetics 95, and satisfaction 84. There were no postoperative neurological complications. No patient required open decompression or transposition. There were no wound complications. This technique addresses all points of possible compression, results in outcomes similar to those reported in the literature, and results in excellent cosmesis. It is a simple and safe technique that avoids the complexities of endoscopy and transposition and has proven to be successful.

Minimal-incision in situ ulnar nerve decompression at the elbow

With initiatives to decrease operative morbidity, complications, and associated costs, minimalincision techniques have found an expanding role within multiple specialties. Minimal-incision in situ open techniques for ulnar nerve release at the elbow provide adequate exposure and reproducible, satisfactory outcomes. Furthermore, there is no need for endoscopic equipment and the resultant dependence on staff adequately trained to operate and troubleshoot equipment. More robust research with a focus on complications and standard outcome measures will be required to further define the role of minimal-incision techniques. This technical modification, however, augments the increasing armamentarium of the hand surgeon.

Surgical treatment of common entrapment neuropathies in the upper limbs

Entrapment neuropathies of the upper extremity are common, debilitating conditions. Most patients with these neuropathies are readily diagnosed on purely clinical grounds and may be effectively managed with nonoperative measures. However, the broad differential diagnosis often necessitates electrodiagnostic testing and radiographic imaging to clarify the situation. This review focuses on three of the most common entrapment neuropathies in the upper limbs: carpal tunnel syndrome (median nerve entrapment at the wrist), cubital tunnel syndrome (ulnar nerve entrapment at the elbow), and radial tunnel syndrome (posterior interosseous nerve entrapment). Anatomical considerations, patient evaluation, indications for surgical intervention, options for surgical approaches, outcomes, and complications are discussed.