World neurosurgery 2017 06 21() pii S1878-8750(17)30954-3
in situ decompression and transposition are equally effective in cubital tunnel syndrome treatment. Both are traditionally performed in the supine position.
to validate our surgical to present our technique for in situ decompression in lateral decubitus position, comparing results with other techniques used in our Institutions.
Retrospective study. Period January 2009-February 2016. 188 cubital tunnel syndrome patients, 115 males, 73 females, age mean 53.44±12.12SD (range 18-84) years. In situ decompression in the lateral or supine positions or transposition (subcutaneous or submuscular). Local anesthesia applied to the lateral decubitus group, brachial plexus block for the rest. Clinical and electrophysiological results between these four groups are compared.
No statistically significant demographic differences between groups. Better results in in situ decompression groups compared to transpositions. Follow-up mean 1511.1±770.57SD (range 310-4203 days). No recurrences or residual elbow pain/dysesthesia/anesthetic scar/hyperesthesia/neuroma in the lateral decubitus group. Complication and recurrence rates with direct correlation to incision size. Worst results seen in transpositions, particularly the submuscular group. In situ decompression in supine position had better results than transpositions but worse than those performed in lateral decubitus. Smaller surgical wound correlates with a reduction in operating time, costs, complication rates and time out of work.
in situ decompression is equally effective as ulnar nerve transpositions but with less complications and recurrences. On lateral decubitus position the retroepicondylar tunnel is more accessible, allowing smaller incisions and better results.