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Cubital tunnel syndrome

Alberto Tagliafico, Bianca Bignotti, Carlo Martinoli
This article is a practical review update on ultrasound (US)-guided interventional procedures on peripheral nerves. Technical considerations, biopsy techniques, and some examples of injections are described. US is considered a safe imaging guidance for interventional procedures, due to its high spatial resolution and the possibility to image the needle and inject drugs in real time. US-guided injections could be considered a diagnostic and therapeutic option in the most common neuropathy, before or as an alternative to surgery...
November 2016: Seminars in Musculoskeletal Radiology
Adam B Strohl, David S Zelouf
In addition to the more common carpal tunnel and cubital tunnel syndromes, orthopaedic surgeons must recognize and manage other potential sites of peripheral nerve compression. The distal ulnar nerve may become compressed as it travels through the wrist, which is known as ulnar tunnel or Guyon canal syndrome. The posterior interosseous nerve may become entrapped in the proximal forearm as it travels through the radial tunnel, which results in a pain syndrome without motor weakness. The median nerve may become entrapped in the proximal forearm, which can result in a variety of symptoms...
January 2017: Journal of the American Academy of Orthopaedic Surgeons
Meng-Ta Liu, Jiunn-Tay Lee, Chih-Hsin Wang, Yu-Chieh Lin, Chung-Hsing Chou
PURPOSE: An uncommon ulnar nerve schwannoma should not be neglected in a diabetic patient with cubital tunnel syndrome, the second most common cause of entrapment neuropathy. CASE REPORT: A 61-year-old woman with a past history of type 2 diabetes mellitus complicated with sensorimotor polyneuropathy presented with progressive numbness and weakness of the left ring and little fingers for one year. A provisional diagnosis of cubital tunnel syndrome was made according to physical examination and electrophysiological studies...
June 15, 2016: Acta Neurologica Taiwanica
Gregor Omejec, Krešimir Božikov, Simon Podnar
OBJECTIVE: To validate the findings of preoperative motor short-segment nerve conduction studies (SSNCSs) by intraoperative SSNCSs in patients with cubital tunnel syndrome. METHODS: We prospectively recruited patients with ulnar neuropathy at the elbow (UNE) localized distal to the medial epicondyle (ME). Preoperatively, motor SSNCSs and ultrasonography (US) were performed. Immediately after surgical dissection of the humeroulnar aponeurotic arcade (HUA), intraoperative near-nerve motor SSNCSs were performed, and compared to preoperative findings...
December 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
J K F Wong, C C Hsu, C H Lin, S H Lien, Y T Lin
BACKGROUND: Many techniques have been described to relieve the compression and reduce subluxation of the ulnar nerve following surgery. The subfascial anterior transposition of the ulnar nerve (SfATUN) is one described technique, but involves a long scar, risk of injury to the medial antebrachial cutaneous nerve, and possible nerve ischemia from anterior transposition. We assessed a more refined approach of endoscopy-assisted SfATUN for the treatment of cubital tunnel syndrome. METHODS: A consecutive case series of 21 patients (15 males and 6 females) with evidence of nerve subluxation after ulnar nerve decompression were operated using an endoscopy-assisted SfATUN...
September 16, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Michael P Gaspar, Hesham M Abdelfattah, Ian W Welch, Michael M Vosbikian, Patrick M Kane, Mark S Rekant
BACKGROUND: Perineural scarring of the ulnar nerve is a predominant cause of symptom recurrence after surgical treatment for primary cubital tunnel syndrome (CuTS). We report our preliminary experience in revision ulnar nerve decompression and nerve wrapping with an amniotic membrane allograft adhesion barrier for treatment of recurrent CuTS. METHODS: We performed a retrospective review with prospective follow-up of patients with recurrent CuTS who were treated with revision neurolysis with amniotic membrane nerve wrapping...
October 14, 2016: Journal of Shoulder and Elbow Surgery
Yi-Ming Ren, Xian-Hu Zhou, Hu-Yun Qiao, Zhi-Jian Wei, Bao-You Fan, Wei Lin, Shi-Qing Feng
OBJECTIVE: We conducted this systematic review and meta-analysis to compare the clinical efficacy and safety between open and endoscopic in situ decompression surgery methods for cubital tunnel syndrome (CuTS). METHODS: PubMed, Medline, Embase, Cochrane Library and CNKI were searched for eligible studies. The data were extracted by two of the coauthors (WL, BYF) independently and were analyzed using RevMan statistical software, version 5.1. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated...
September 12, 2016: International Journal of Surgery
Lauren E Wessel, Duretti T Fufa, R Bruce Canham, Adam La Bore, Martin I Boyer, Ryan P Calfee
BACKGROUND: Double crush syndrome, the association between proximal and distal nerve lesions, has been established. This investigation compares the outcomes of nerve surgery in patients with isolated peripheral compression versus those with double crush syndrome treated with peripheral nerve and cervical spine operations. METHODS: This case-controlled study enrolled 80 patients: 40 underwent carpal or cubital tunnel surgery and cervical spine surgery (double crush group); and 40 controls, matched by age and sex, underwent only peripheral nerve decompression (peripheral nerve group)...
January 2017: Plastic and Reconstructive Surgery
Elizabeth M Pinder, Chye Yew Ng
The scratch collapse test (SCT) is a relatively new clinical test in which a positive result implies entrapment neuropathy of the nerve tested. Initially described for carpal and cubital tunnel syndromes, subsequent authors have found it useful for the assessment of median, ulna, radial, axillary, and common peroneal nerves. We report a case illustrating the value of the SCT in the clinical assessment of thoracic nerve entrapment.
August 2016: Journal of Hand and Microsurgery
Ahmed F Sadek, Ezzat H Fouly, Adel A Abdel-Aziz, Mohammed A Sayed, Nehad M El-Mahboub, Mona Hamdy
PURPOSE: The aim of this study was to compare the functional and neurophysiological outcome of in situ decompression versus in situ decompression augmented with autogenous vein wrapping in management of secondary cubital tunnel syndrome at the elbow following fixation of elbow fractures. METHODS: A prospective comparative randomized study was performed on 29 patients who were divided into two groups: group I (in situ decompression) and group II (in situ decompression augmented with autogenous vein wrapping)...
April 2016: Journal of Hand and Microsurgery
Taku Suzuki, Takuji Iwamoto, Kensuke Ochi, Kazuaki Mito, Toshiyasu Nakamura, Katsuji Suzuki, Harumoto Yamada, Kazuki Sato
INTRODUCTION: The aim of this study was to validate the potential association between cigarette smoking and cubital tunnel syndrome (CubTS). METHODS: One hundred patients with CubTS were compared with 100 controls with ulnar abutment syndrome matched for age, gender, and body mass index. The smoking status was compared between patients and controls using the sign test and the Wilcoxon signed rank test. Conditional logistic regression was used to calculate the association between CubTS and pack-years smoked...
December 2016: Muscle & Nerve
Ian Foran, Kenneth Vaz, Jakub Sikora-Klak, Samuel R Ward, Eric R Hentzen, Sameer B Shah
PURPOSE: Simple decompression and anterior subcutaneous transposition are effective surgical interventions for cubital tunnel syndrome and yield similarly favorable outcomes. However, a substantial proportion of patients demonstrate unsatisfactory outcomes for reasons that remain unclear. We compared effects of decompression and transposition on regional ulnar nerve strain to better understand the biomechanical impacts of each strategy. METHODS: Patients diagnosed with cubital tunnel syndrome and scheduled for anterior subcutaneous transposition surgery were enrolled...
October 2016: Journal of Hand Surgery
Peter Tang, Jason S Hoellwarth, Aakash Chauhan
No abstract text is available yet for this article.
March 8, 2016: JBJS Reviews
Salah Aldekhayel, Alexander Govshievich, James Lee, Youssef Tahiri, Mario Luc
BACKGROUND: Several surgical techniques exist for treatment of cubital tunnel syndrome. Endoscopic cubital tunnel release (ECTuR) has been recently reported as a promising minimally invasive technique. This study aims to compare outcomes and complications of open cubital tunnel release (OCTuR) and ECTuR in the treatment of idiopathic cubital tunnel syndrome. METHODS: A systematic review of the literature (1980-2014) identified 118 citations. Studies including adults with idiopathic cubital tunnel treated exclusively by ECTuR or OCTuR were included...
March 2016: Hand: Official Journal of the American Association for Hand Surgery
Peter C Chimenti, Allison W McIntyre, Sean M Childs, Warren C Hammert, John C Elfar
BACKGROUND: Resolution of symptoms including pain, numbness, and tingling outside of the median nerve distribution has been shown to occur following carpal tunnel release. We hypothesized that a similar effect would be found after combined release of the ulnar nerve at the elbow with simultaneous release of the median nerve at the carpal tunnel. METHODS: 20 patients with combined cubital and carpal tunnel syndrome were prospectively enrolled. The upper extremity was divided into six zones and the location of pain, numbness, tingling, or strange sensations was recorded pre-operatively...
2016: Open Orthopaedics Journal
Yoshikazu Ido, Shigeharu Uchiyama, Koichi Nakamura, Toshiro Itsubo, Masanori Hayashi, Yukihiko Hata, Toshihiko Imaeda, Hiroyuki Kato
We investigated a recovery pattern in subjective and objective measures among 52 patients with cubital tunnel syndrome after anterior subcutaneous transposition of the ulnar nerve. Disabilities of the Arm, Shoulder and Hand (DASH) score (primary outcome), numbness score, grip and pinch strength, Semmes-Weinstein (SW) score, static 2-point discrimination (2PD) score, and motor conduction velocity (MCV) stage were examined preoperatively and 1, 3, 6, 12, and ≥24 months postoperatively. Statistical analyses were conducted to evaluate how each variable improved after surgery...
2016: Scientific Reports
David Kachlik, Marek Konarik, Jitka Riedlova, Vaclav Baca
This article reviews in detail the superficial brachiomedian artery (arteria brachiomediana superficialis), a very rare variant of the main arterial trunks of the upper limb. It branches either from the axillary artery or the brachial artery, descends superficially in the arm (similar to the course of the superficial brachial artery) and continues across the cubital fossa, runs superficially in the forearm, approaches the median nerve and enters the carpal canal to reach the hand. It usually terminates in the superficial palmar arch...
March 10, 2016: Bosnian Journal of Basic Medical Sciences
Zhu Liu, Zhi-Rong Jia, Ting-Ting Wang, Xin Shi, Wei Liang
BACKGROUND: The appropriate elbow position of short-segment nerve conduction study (SSNCS) to diagnose cubital tunnel syndrome (CubTS) is still controversial. The goal of this study was to determine the effect of different elbow positions at full extension and 70° flexion on SSNCS in CubTS. METHODS: In this cross-sectional study, the clinical data of seventy elbows from 59 CubTS patients between September, 2011 and December, 2014 in the Peking University First Hospital were included as CubTS group...
May 5, 2016: Chinese Medical Journal
Jordan M Brown, Corrie M Yablon, Yoav Morag, Catherine J Brandon, Jon A Jacobson
Ultrasonography (US) has become a first-line modality for the evaluation of the peripheral nerves of the upper extremity. The benefits of US over magnetic resonance (MR) imaging include higher soft-tissue resolution, cost effectiveness, portability, real-time and dynamic imaging, and the ability to scan an entire extremity quickly and efficiently. US can be performed on patients who are not eligible for MR imaging. Metallic implant artifacts are usually not problematic. US has been shown to have equal specificity and greater sensitivity than MR imaging in the evaluation of peripheral nerves...
March 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Sang-Uk Lee, Min-Wook Kim, Jae Min Kim
Double compression of the ulnar nerve, including Guyon's canal syndrome associated with cubital tunnel syndrome caused by the anconeus epitrochlearis muscle, is a very rare condition. We present a case of double crush syndrome of the ulnar nerve at the wrist and elbow in a 55-year-old man, as well as a brief review of the literature. Although electrodiagnostic findings were consistent with an ulnar nerve lesion only at the elbow, ultrasonography revealed a ganglion compressing the ulnar nerve at the hypothenar area and the anconeus epitrochlearis muscle lying in the cubital tunnel...
January 2016: Journal of Korean Neurosurgical Society
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