An Approach to Surgery for Cubital Tunnel Syndrome A Pilot Series

Background: Cubital tunnel syndrome and the resulting loss of hand dexterity and strength may necessitate surgical management. Studies have demonstrated no difference in outcome between surgical techniques. In an attempt to leave more ulnar nerves in situ while providing for stability within the cubital tunnel, we suggest a surgical treatment approach. Methods: The approach addresses individual anatomy methodically, eliminating muscular obstruction first and providing further decompression and stability as required. A retrospective review of 27 adult patients with ulnar neuropathy treated according to this method was performed. Results: The mean duration of symptoms prior to surgery was 2.75 years (SD = 2.4). The mean follow-up was 17.1 months (SD = 16.9). All patients improved following surgery. Two revision surgeries were performed 4 years following the original surgery. Conclusions: We believe the nerve recovers best when left in situ, provided it is stable and not compressed within the cubital tunnel. A further comparison study is necessary to substantiate the advantage of this "personalized" approach over other surgical techniques for cubital tunnel release.