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Dr. ahmed.mustafa :: Publications:

Feasibility and Outcome of Endoscopic Ulnar Nerve Release in Cubital Tunnel Syndrome
Authors: Ahmed Saleh, MD
Year: 2010
Keywords: Cubital tunnel syndrome, Endoscopic release Abbreviations: postoperative (PO), ulnar nerve (UN), flexor carpi ulnaris (FCU), cubital tunnel syndrome (CTS)
Journal: Not Available
Volume: Not Available
Issue: Not Available
Pages: Not Available
Publisher: Not Available
Local/International: International
Paper Link: Not Available
Full paper ahmed.mustafa_Cubital Tunnel-19-12-10.doc
Supplementary materials Not Available

Objectives: To evaluate the surgical short-term outcome of endoscopic ulnar nerve release in patients with cubital tunnel syndrome (CTS) after at least 6-months postoperative (PO) follow-up. Patients & Methods: The study included 17 patients; 10 males and 7 females with mean age of 31.9±5; years. The dominant hand was affected in 9 patients (52.9%) with a mean duration of the complaints of 15±5.5 months and mean duration of preoperative conservative treatment of 8.4±2.7 months. There were 2 patients (11.8%) Dellon's grade 1, 14 patients (82.3%) were Dellon's grade 2 and one patient (5.9%) was Dellon's grade 3. Preoperative nerve conduction studies, both sensory and motor were conducted to confirm ulnar nerve compression at elbow level. All patients underwent endoscopic release under general anesthesia and were followed up daily for one week, weekly for one month and then three monthly. Outcome was judged using Modified Bishop rating system. Results: Proximal endoscopic advancement was failed in one case (5.9%) and nerve release was completed through an open incision. Fourteen patients (82.4%) reported significant improvement of symptoms within the first PO 24 hours, 2 patients (11.7%) reported similar improvement on the 2nd PO day, while the patient (5.9%) who had open completion reported improvement on the 6th PO day. Thirteen patients had full elbow motion within 72 hours after surgery and 4 patients within a week. After a mean follow-up duration of 12.5±2 months, 15 patients documented better improvement, 10 patients became asymptomatic, 11 patients regained their grip strength, 14 patients had improved sensibility and 15 patients returned to their preoperative job. Thus, according to modified Bishop Rating System, 12 patients (70.6%) had excellent outcome, 4 patients (23.5%) had good result and only one patient (5.9%) had fair result with a total mean score of 7.8±1.3; range: 4-9. All patients showed PO improvement of nerve conduction velocity compared to preoperative one. Four patients had PO minor complications that resolved spontaneously. No recurrence was reported. Conclusion: Endoscopic cubital tunnel release of entrapped ulnar nerve is feasible, safe and easy procedure with procedural success rate of 94.1% and high successful outcome. Moreover, it provides small cosmetically acceptable wound with minimal PO complications and could be managed as one-day surgery.

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