A tailored approach to the surgical treatment of cubital tunnel syndrome.

Abstract

Multiple studies have compared the outcome of surgery for cubital tunnel syndrome (CUTS), yet there remains no clear guidelines for treatment. We describe an approach to CUTS that includes tailoring the procedure to the pathology found at surgery. Patients treated surgically were retrospectively reviewed. Following in situ neurolysis, nerve stability within the cubital tunnel was assessed, and the nerve was left in situ, or transposed accordingly. We evaluated demographic information, presenting features, intraoperative and postoperative findings. Statistics included paired t test and logistic regression analysis. A total of 63 patients (standard deviation = 10.3 years) were reviewed. Fourteen nerves were transposed (22.5%). Postoperatively, sensation (71%), static 2-point discrimination, and motor strength improved. Grip strength compared with the uninvolved side was 94.8% postoperatively. Overall, 90% of the patients reported improvement in function. Our results compare favorably with other studies. Since CUTS originates from numerous causes, basing the operative plan on intraoperative findings produces excellent results.