[Results of endoscopic decompression of the ulnar nerve in the cubital tunnel syndrome].

PURPOSE: Aim of this study was to evaluate our own results after endoscopic decompression of the ulnar nerve in cubital tunnel syndrome (CuTS) and to compare them with those in the literature.

PATIENTS AND METHOD: Between April 2005 and April 2006 52 patients with clinically and neurologically verified CuTS received an endoscopic decompression of the ulnar nerve. Patients with concomitant pathology or recurrent disease were excluded. Pre- and postoperatively, the history was taken and an extensive clinical examination was carried out. Grip strength and pinch strength were measured, as was the static two-point discrimination. All ulnar nerve-innervated muscles were tested for their neurological muscle power. Tinel's sign, Froment's sign and the elbow flexion test were examined. Nerve subluxation was documented. All patients underwent nerve conduction studies with documentation of the velocity distal and proximal of the cubital tunnel. 47 patients (90%) were available for re-evaluation after eight months. The results were evaluated using the Dellon classification and the modified Bishop rating system. According to the Dellon classification 10 patients had mild, 21 moderate and 16 severe CuTS. Statistical significance was verified using the Wilcoxon test. All operations, as described by Hoffmann and Siemionow, were performed only by the author.

RESULTS: In 94% of the followed patients sensibility was normalised. Grip strength improved from 75% of the contralateral side to 94%. The proximal nerve conduction velocity improved significantly postoperatively. According to the modified Bishop rating system 31 patients (66%) had an excellent, 15 patients (32%) a good and 1 patient (2%) a fair result. There were no poor results. On average, patients reached 7.7 points on the Bishop scale; those patients with stage Dellon III alone reached 7.5 points. Complications included subcutaneous harmless haematomas in 4% of all cases and a laceration of a single motor branch of the ulnar nerve innervating the flexor carpi ulnaris in two patients with restitutio ad integrum.

CONCLUSION: In this study endoscopic decompression of the ulnar nerve in CuTS proved to be a patient-oriented and excellent method with very good, reproducible results, even in Dellon III patients.