Transposition versus Decompression Alone for Ulnar Nerve Entrapment in Cubital Tunnel

Abstract

Background: Cubital tunnel syndrome is the most common form of ulnar nerve entrapment (UNE).
Objective: The aim of the present study was to evaluate patient-reported and surgeon-evaluated outcome of ulnar nerve entrapment in cubital tunnel decompression versus transposition.
Patients and methods: The study was conducted on 18 ulnar nerve entrapment patients 9 cases underwent simple decompression operation and 9 cases underwent transposition operation. All cases were subjected to electrodiagnostic tests. Post-operative outcomes were assessed and graded, based on patient-reported and surgeon-evaluated outcome, into four groups: cured, improved, unchanged or exacerbated.
Results: Our study showed that 88.9% of the decompression group showed full motor power (FMP) postoperatively while this was shown in 44.4% of transposition group with significant difference (P < 0.05) between the two groups. All patients of both groups showed postoperative improved sensory manifestations. There was highly significant difference (p < 0.05) between the two studied groups regarding postoperative nerve conduction velocity (NCV) as it was higher in decompression group than transposition group . while there was no significant difference between them regarding nerve thickness by ultrasound.
Conclusion: Simple decompression is associated with less operative time, less amount of blood loss, smaller wound, less exposure to nerve, less need to affect elbow joint except in large deformation than surgical treatment with transposition.