In situ ulnar nerve decompression at the cubital tunnel via a small incision with electromyography localization

• DOI: 10.3760/cma.j.issn.1005-054x.2011.02.013
• Publication Date: 2011-04-10
• Authors: Ruijun Li; Laijin Lu; Zhixin Zhang
• Keywords: Cubital tunnel; Epicondyle; Flexor Carpi Ulnaris

Objective To evaluate the therapeutic effect of in situ ulnar nerve decompression at cubital tunnel via a small incision assisted with electromyography localization and discuss surgical indications.Methods Twelve patients who were diagnosed idiopathic syndrome (CuTS) without intrinsic muscle atrophy elbow deformity involved study.Before operation, short-segment conduction test (SSCT) was carried out.The exact compression site determined by ＞ 50%reduction amplitude or 0.5 ms lengthening latency action potentials recorded upon stimulation around 1 cm intervals.An release performed.Compression observed documented to verify accuracy pre-operative SSCT localization.Results Intraoperative findings confirmed that lesions located from 3 above below medial epicondyle, which coincided sites SSCT.All reported alleviation hand discomfort postoperatively.Follow-up months postoperatively showed paresthesia distribution disappeared.Pinprick sensation recovered.There no subjective measurable weakness pinch grip strength clumsiness loss coordination.Claw disappeared.Six after surgery, abductor digiti minimi returned normal.Two-point discrimination little finger 5.0 mm on average.Nerve velocity 45.0 m/s.Action potential increased yielded positive findings.Mild reversed one year postoperatively.Elbow flexion test, Tinel' s sign Froment' all negative.Conclusion In is suitable procedure for certain CuTS cases.

Key words: Cubital syndrome; Electromyography; Ulnar