gms | German Medical Science

Objective: The treatment of cubital tunnel syndrome (CubTS) is still controversially discussed. Endoscopic long-distance decompression has recently been introduced and since then has shown promising results. Its role when dealing with (sub-)luxation of the ulnar nerve has not yet been elucidated. We present our experience with the endoscopic technique with special regard to the patients suffering from ulnar nerve (sub-)luxation.

Methods: 41 patients with CubTS treated endoscopically were followed over 13 months on average (median 13 months). 36 were male, 5 female. In 17 cases the right side, and in 34 cases the left side was affected. Overall, 6 had mild (Dellon I), 23 moderate (Dellon II), and 12 severe (Dellon III) symptoms. 4 presented with a (sub-)luxating ulnar nerve. We did the operations according to Hoffmann’s technique using a commercially available endoscopic system and instruments.

Results: 31 patients achieved very good results (Bishop scale I), 2 good (Bishop II), 6 fair (Bishop III), and 2 bad results (Bishop IV), respectively. The mean decompression distance was about 14 cm. In all patients with (sub-)luxating nerve Bishop grade I could be achieved, and so far none of them required secondary surgery. Nonetheless, one patient (with a previously not luxating nerve) underwent submuscular transposition 15 months after endoscopic decompression due to recurrent symptoms.

Conclusions: In our initial experience endoscopic release of the ulnar nerve in CubTS is a safe and feasible technique leading to good and very good results (33/41). Seemingly even (sub‑)luxating nerves can be released in this manner without a higher risk of further operations. Restrictions apply due to limited follow-up periods. Of course, further and larger studies have to clarify this issue.