Ulnar Nerve in Situ Decompression versus Transposition for Idiopathic Cubital Tunnel Syndrome: Long-term clinical outcome: Multicenteric retrospective study

Abstract

Background: Cubital tunnel syndrome is one of the most frequent upper extremity entrapment neuropathies. The best surgical therapy for cubital tunnel syndrome is unknown.Our goal is to compare the results of the different methods proposed and correlate preoperative findings guided by electrodiagnostic studies and intraoperative findings regarding accurate sites of ulnar nerve compression at the cubital tunnel in both surgical approaches to assess the long-term clinical outcome of surgical management. Materials and methods: From 2012 to 2018, we looked at 79 individuals who had cubital tunnel syndrome and were managed with two different surgical procedures. To validate the diagnosis and locate locations of ulnar nerve entrapment in the cubital tunnel, preoperative electrodiagnostic tests were done. Preoperative clinical symptoms were identified using Dellon's staging approach, and postoperative clinical outcome was assessed using a modified Bishop rating system in all patients.Results: The outcomes were graded excellent in 61 patients , good in 15 patients , and fair in three patients . Electrodiagnostic studies are not accurate in detecting the actual number of sites of ulnar nerve entrapment, while intraoperative results were more accurate. Conclusions: In situ decompression is as beneficial as anterior transposition in the treatment of cubital tunnel syndrome, according to our findings. When compared to intraoperative results, electrodiagnostic investigations perform poorly in diagnosing the precise locations of ulnar nerve compression.