As a rare cause of cubital tunnel syndrome, we report a case of cubital tunnel syndrome caused by Schwannoma of the ulnar nerve. Enucleation and subcutaneous anterior transposition of the ulnar nerve resulted in complete relief of the patient's symptoms.
Cubital Tunnel Syndrome ; Neurilemmoma ; Ulnar Nerve

PURPOSE: The purpose of this prospective study is to examine the anatomical variations of the branches of the medial antebrachial cutaneous nerve in Koreans encountered during cubital tunnel surgery. METHODS: Ninety two patients with cubital tunnel syndrome were treated with a standard approach from December 2008 to July 2012. The position of the branches of medial antebrachial cutaneous nerve was evaluated based on the medial humeral epicondyle with the elbows fully extended. RESULTS: At least one medial antebrachial cutaneous nerve branch was found during the surgeries in all patients. The average number of crossing medial antebrachial cutaneous nerve branches per patient was 1.6. Thirty-eight percent of the cases showed that the medial cutaneous nerve branches cross proximal to the medial humeral epicondyle within 1 cm. Eighty-two percent showed that the medial antebrachial cutaneous nerve branches cross distal to the medial humeral epicondyle within 1.9 cm. CONCLUSION: When using standard approach during cubital tunnel surgery, more than one medial forearm cutaneous nerve is found. Therefore, understanding the general position of medial antebrachial cutaneous nerve branches helps avoid iatrogenic damage to this nerve during cubital tunnel surgery.
Cubital Tunnel Syndrome ; Elbow ; Forearm ; Humans ; Prospective Studies

Cubital tunnel syndrome is the second most common compressive neuropathy. Its diagnosis is largely based on clinical findings. It has been well known that patients with mild to moderate grade of cubital tunnel syndrome have a high chance of spontaneous resolution, while those with severe degree do not. Thus, the former is treated with conservative methods initially, and the latter is indicated for surgical intervention. There are three types of surgical techniques for cubital tunnel syndrome. Of these, in-situ decompression technique has been gaining popularity as it is simpler and shows similar efficacy with less complications compared to other techniques. In this review, we deal with current concepts of the cubital tunnel syndrome pertaining to the primary clinical practice.
Cubital Tunnel Syndrome ; Decompression ; Diagnosis ; Humans ; Ulnar Nerve ; Ulnar Neuropathies*

PURPOSE: To evaluate the surgical outcomes and the clinical factors affecting the results of subcutaneous anterior transposition of the ulnar nerve in cubital tunnel syndrome. MATERIALS AND METHODS: Eighteen patients diagnosed as having cubital tunnel syndrome and treated by subcutaneous anterior transposition of ulnar nerve were investigated retrospectively. According to preoperative Dellon's staging, 2 patients (11%) were in mild stage, 5 (28%) in moderate and 11 (61%) in severe. Results were evaluated using Dellon's staging and Mowlavi's classification. RESULTS: According to Mowlavi's outcome status, 2 patients (11%) showed total relief, 10 (56%) improvement, 5 (28%) no change and 1 (6%) was worse, therefore the results were satisfactory in 12 patients (67%). Patients with less severe symptoms received surgery within a year of symptom onset and showed better results. CONCLUSION: The result of subcutaneous anterior transposition of ulnar nerve in cubital tunnel syndrome is comparable to that of other surgical methods, but it is easier technically. Better results may be anticipated when surgery is performed within a year of symptom onset.
Classification ; Cubital Tunnel Syndrome* ; Humans ; Retrospective Studies ; Ulnar Nerve*

PURPOSE: The aim of this study was to compare the results of medial epicondylectomy and anterior submuscular transposition of the ulnar nerve in patients with primary cubital tunnel syndrome. MATERIALS AND METHODS: Thirty patients with primary cubital tunnel syndrome formed the basis of this study. Eighteen patients underwent medial epicondylectomy and twelve patients underwent anterior submuscular transposition of the ulnar nerve. The mean follow-up period was 35 months. Postoperative clinical results were assessed using Gabel and Amadio's rating scale which evaluats pain, sensory and motor function in four grades. Clinical results were compared between two groups in McGowan grades two and three. RESULTS: Two excellent, twelve good and six fair results were obtained in patients with McGowan grade II. In McGowan grade III, three were good, six fair and one was poor. No significant difference in the results was observed between two surgical groups. CONCLUSION: Medial epicondylectomy and anterior submuscular transposition of the ulnar nerve showed no difference in results between patients with primary cubital tunnel syndrome. It seems that medial epicondylectomy is more appropriate because of its simplicity during operation and in terms of postoperative management.
Cubital Tunnel Syndrome* ; Follow-Up Studies ; Humans ; Ulnar Nerve*

Postoperative heterotopic ossification of the elbow after surgery for treatment of acute trauma such as fractures and ligament/tendon ruptures has been well-documented. However, literature concerning heterotopic ossification after medial epicondylectomy is scarce. We report on two cases of heterotopic ossification that occurred following medial epicondylectomy for medial epicondylitis and for cubital tunnel syndrome. Preoperatively, calcifications around the medial epicondyle were observed in both patients. These cases suggest that medial epicondylectomy, in the presence of pre-existing calcifications, may pose an increased risk of postoperative heterotopic ossification of the elbow.
Cubital Tunnel Syndrome ; Elbow* ; Humans ; Ossification, Heterotopic* ; Rupture

BACKGROUND: The aim of this study was to assess the consistency between preoperative ultrasonographic and intraoperative measurements of the ulnar nerve in patients with cubital tunnel syndrome. METHODS: Twenty-six cases who underwent anterior transposition of the ulnar nerve for cubital tunnel syndrome were enrolled prospectively. On preoperative ultrasonography, largest cross-sectional diameters of the ulnar nerve were measured at the level of medial epicondyle (ME) and 3 cm proximal (PME) and distal (DME) to the ME on the transverse scan by a single experienced radiologist. Intraoperative direct measurements of the largest diameter at the same locations were performed by a single surgeon without knowledge of the preoperative values. The consistency between ultrasonographic and intraoperative values including the largest diameter and swelling ratio were assessed. RESULTS: Significant differences between ultrasonographic and intraoperative values of the largest diameter were found at all levels. The mean difference was 1.29 mm for PME, 1.38 mm for ME, and 1.12 mm for DME. The mean ME-PME swelling ratio for ultrasonographic and intraoperative measurements was 1.50 and 1.39, respectively, showing significant difference. The mean ME-DME swelling ratio for ultrasonographic and intraoperative measurements was 1.53 and 1.43, respectively, showing no significant difference. CONCLUSIONS: Ultrasonographically measured largest diameters of the ulnar nerve at any levels were smaller than the real values determined intraoperatively. The ME-DME swelling ratio of the ulnar nerve measured by ultrasonography was consistent with the intraoperative measurement.
Cubital Tunnel Syndrome* ; Humans ; Prospective Studies ; Ulnar Nerve ; Ultrasonography*

OBJECTIVE: The purpose of this study is to evaluate the arteiovenous fistula effects on peripheral nerve in patients with chronic renal failure by nerve conduction studies. METHOD: Nerve conduction studies were performed in 23 patients with chronic renal failure. We not only measured distal latencies, amplitudes, and conduction velocities of median and ulnar motor nerves but also measured same parameters of radial sensory nerves at both upper limbs. In case of pateints with suspected peripheral polyneuropathy, we checked peripheral nerves at one lower limb. The results of nerve conduction studies and the frequency of cubital tunnel syndrome or carpal tunnel syndrome were compared between arteiovenous fistula side and non-arteiovenous fistula side. RESULTS: The amplitudes of median motor, ulnar motor nerves and radial sensory nerve in arteiovenous fisula side are statistically lower than those in non-arteiovenous fisula side (p<0.05). In the 14 patients with peripheral polyneu ropathy, the difference is also statistically significant between two sides (p<0.05). Compared arteiovenous fisula side with non-arteiovenous fisula side, the frequency of cubital tunnel syndrome or carpal tunnel syndrome was not different between two sides. CONCLUSION: Arteiovenous fisula may damage to the peripheral nerve in patients with chronic renal failure.
Carpal Tunnel Syndrome ; Cubital Tunnel Syndrome ; Fistula* ; Humans ; Kidney Failure, Chronic* ; Lower Extremity ; Neural Conduction ; Peripheral Nerves* ; Polyneuropathies ; Upper Extremity

Cubital tunnel syndrome is the second most common nerve entrapment syndrome affecting the upper extremity. Surgical treatment is indicated for those who have motor weakness or when conservative measures have failed. Several different surgical techniques have been introduced, however, the optimal treatment for cubital tunnel syndrome is still under debate. In the recent years, well-performed prospective randomized studies show that there is no difference in outcome among various surgical techniques regardless of the severity and presence of subluxation. It is advised that in situ decompression is the preferred technique because it is simpler and less time consuming procedure. Although in situ decompression is effective in uncomplicated ulnar nerve subluxation, anterior transposition should be considered when the subluxation is painful or when the ulnar nerve actually snaps back and forth over the medial epicondyle. Anterior transposition of the ulnar nerve is still indicated for revision surgery, previous trauma around the elbow, distal humerus fractures, severe osteoarthritis needing medial spur excision, and severe valgus deformity of the elbow.
Congenital Abnormalities ; Cubital Tunnel Syndrome ; Decompression ; Elbow ; Humerus ; Nerve Compression Syndromes ; Osteoarthritis ; Ulnar Nerve ; Upper Extremity

OBJECTIVE: The purpose of this study is to review the results of two surgical methods of simple decompression for treatment of cubital tunnel syndrome. METHODS: Surgical procedure of simple decompression of the ulnar nerve using the conventional method requires a relatively long incision of 6-8 cm. Later with accumulating experience, we performed simple decompression using a skin incision of 2 cm or less. Between November 2005 and July 2010, simple decompression using the conventional method was performed in 10 elbows (Group 1), and simple decompression using the small skin incision method was performed in 10 elbows (Group 2). The surgical outcome was evaluated and the two groups were compared using a modified Bishop scoring system. We also compared the operation time and hospital stay between the two groups. RESULTS: There were no significant differences in the outcomes between the two groups using the modified Bishop scoring system (p>0.05). Also, there were no significant differences in the postoperative electrodiagnostic study results between the two groups (p>0.05). However, the operation time and hospital stay were significantly shorter in Group 2 (p<0.01). CONCLUSION: Both the methods can be recommended for the treatment of cubital tunnel syndrome due to their advantages including simplicity and safety of the method. However, the small skin incision method is superior to the conventional method due to the shorter operation time and hospital stay.
Cubital Tunnel Syndrome ; Decompression ; Elbow ; Length of Stay ; Lipids ; Quaternary Ammonium Compounds ; Skin ; Ulnar Nerve