الفهرس | Only 14 pages are availabe for public view |
Abstract Cubital tunnel syndrome is commonly encountered representing the second most common entrapment neuropathy in the upper limb. Patients with compression of the ulnar nerve at the elbow often present with symptoms of pain, paraesthesia or weakness. The diagnosis may be confirmed by physical examination and EDS. When symptoms are mild, conservative treatment may be considered. Moderate stages of compression have the best outcomes after operative intervention. Treatment options range from simple decompression to transposition of the ulnar nerve to either a subcutaneous, intramuscular or submuscular position. To date, simple decompression seems to have similar objective outcomes to the more invasive transposition procedures. Many surgeons believe that postoperative scarring due to the length of the incision contributes to compromised results from these procedures. Additionally, anterior transposition has been shown to devascularize the ulnar nerve. A recent meta-analysis comparing simple decompression with transposition found no statistically significant difference in outcome. Thirty surgeries for ulnar neuropathy at the elbow were done. The patients were divided into 3 groups for comparison with each group including 10 patients: group A (simple decompression), group B (anterior subcutaneous transposition) and group C (anterior intramuscular transposition). Preoperative evaluation of each patient included history, clinical examination, radiographs, and EDS in addition to the preoperative Gabel and Amadio scoring. The results of our study demonstrate that the two surgical approaches, simple decompression and anterior subcutaneous transposition are equally effective in the treatment of cubital tunnel syndrome. While the anterior intramuscular transposition approach has low recovery rate compared to the other 2 procedures. |