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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Ulnar Nerve Entrapment at The Cubital Tunnel. To Transpose Widely or not to Transpose at all?

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  • presenting/speaker Daniela Pereira - Centro Hospitalar de Leiria, Leiria, Portugal
  • Sérgio Figueiredo - Centro Hospitalar de Leiria, Leiria, Portugal
  • Vítor Rodrigues - Centro Hospitalar de Leiria, Leiria, Portugal
  • Carlos Ferreira - Centro Hospitalar de Leiria, Leiria, Portugal
  • António Sá - Centro Hospitalar de Leiria, Leiria, Portugal

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1212

doi: 10.3205/19ifssh0076, urn:nbn:de:0183-19ifssh00761

Published: February 6, 2020

© 2020 Pereira et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Ulnar nerve entrapment at the cubital tunnel is the second most common peripheral neuropathy, right after carpal tunnel syndrome. Surgical approaches differ, from the standard treatment of care, ulnar nerve release followed by anterior transposition, to novel minimally invasive approaches performed in outpatient surgery. The objective was to compare outcomes achieved after either minimally invasive neurolysis or ulnar nerve transposition when treating ulnar nerve entrapment at the cubital tunnel.

Methods: We performed a retrospective cohort study with all 19 patients suffering from ulnar nerve entrapment at the cubital tunnel who were submitted to surgery, for 5 years, in our institution. Minimally invasive neurolysis was performed in 5 patients, while complete ulnar nerve transposition was performed in 14. The observed ratio between ulnar nerve entrapment at the cubital tunnel versus carpal tunnel syndrome was 1:78. Pre and post-operative nerve conduction study/electromyography data was collected and compared for outcome. Non-parametric tests were performed, assuming statistical significance whenever p<0.05.

Results and Conclusions: Minimally invasive neurolysis offered a better outcome on nerve conduction study/electromyography data, nearly achieving statistical significance (p=0,065). None of the ipsilateral upper limb neurocompressive complaints (9 patients, 2 for minimally invasive neurolysis, 7 for ulnar nerve transposition), obesity (7 patients, 1 and 6, respectively) or Diabetes Mellitus (3 patients, all submitted to ulnar nerve transposition) were related with a worse outcome (p=0,134; p=0,978; p=0,459).

Minimally invasive neurolysis offered a better outcome on nerve conduction study/electromyography data, nearly achieving statistical significance (p=0,065). None of the ipsilateral upper limb neurocompressive complaints (9 patients, 2 for minimally invasive neurolysis, 7 for ulnar nerve transposition), obesity (7 patients, 1 and 6, respectively) or Diabetes Mellitus (3 patients, all submitted to ulnar nerve transposition) were related with a worse outcome (p=0,134; p=0,978; p=0,459).