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Tech Hand Up Extrem Surg 2020 Dec 18. Epub 2020 Dec 18.

*Microsurgery Centre of Latvia †Faculty of Medicine, Riga Stradiņš University, Latvia, European Union.

Cubital tunnel syndrome (CubTS) is one of the most common compression-traction neuropathy in the upper extremity. The gold standard is simple in situ decompression with revision of potential compression sites through skin incision as small as rationally possible. Properly conducted conservative treatment is more effective in CubTS as opposed to carpal tunnel syndrome. Read More

J Clin Neurosci 2021 May 5;87:8-16. Epub 2021 Mar 5.

Murdoch Children's Research Institute, Melbourne, Victoria, Australia.

Submuscular transposition (SMT) for treatment of ulnar nerve entrapment is commonly performed, however published comparisons of surgical techniques exclude a high proportion of the at-risk population encountered in real world practice. To examine the influence of risk factors on the clinical outcome following SMT we performed a retrospective review of all patients who underwent SMT, including patient self-reported outcome and Louisiana State University Medical Centre ulnar nerve grading scale. A total of 403 ulnar nerves were operated, with follow-up data available for 385 cases (359 patients). Read More

Clin Geriatr Med 2021 May 23;37(2):241-252. Epub 2021 Mar 23.

Florida Atlantic University, Charles E. Schmidt College of Medicine, Boca Raton, FL, USA; Marcus Neuroscience Institute, Boca Raton Regional Hospital, 800 Meadow Road, Boca Raton, FL 33486, USA.

Compression neuropathies, also known as entrapment neuropathies, are common neurologic conditions seen in medicine. These often are due to mechanical injury, either compression or stretch of the affected nerve, and initially result in focal demyelinating changes. If left untreated, secondary axonal injury and lasting disability can result. Read More

Hand Surg Rehabil 2021 Apr 1. Epub 2021 Apr 1.

Hand and Microsurgery Unit of the Jewish Hospital of Rome (Ospedale Israelitico), via Fulda 14, 00148 Rome RM, Italy.

Ulnar tunnel syndrome is the second most common upper-limb peripheral nerve compression syndrome. Recurrence or persistence of symptoms after primary surgery is found in 9.9%-21% of cases. Read More

Hand (N Y) 2021 Apr 2:1558944721998022. Epub 2021 Apr 2.

Washington University in St. Louis, MO, USA.

Background: Our management of cubital tunnel syndrome has expanded to involve multiple adjunctive procedures, including supercharged end-to-side anterior interosseous to ulnar nerve transfer, cross-palm nerve grafts from the median to ulnar nerve, and profundus tenodesis. We also perform intraoperative brief electrical stimulation in patients with severe disease. The aims of this study were to evaluate the impact of adjunctive procedures and electrical stimulation on patient outcomes. Read More

Arch Bone Jt Surg 2021 Jan;9(1):85-92

Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA.

Background: There is a growing interest in engaging patients in research priorities and project design. This study compared topics patients and surgeons would like to address in upper extremity musculoskeletal research.

Methods: We invited patients on social media-based support groups for specific musculoskeletal illnesses and members of the Science Of Variation Group to indicate the three most important research topics by disease. Read More

No Shinkei Geka 2021 Mar;49(2):452-457

Department of Neurosurgery, Yokohama Brain and Spine Center.

Case 1: A 73-year-old man who had undergone neurolysis for right cubital tunnel syndrome complained of difficulty using chopsticks. Froment's sign test showed that the interphalangeal(IP)joint of the right thumb that had flexed preoperatively was extended. This finding was considered to indicate recovery from ulnar neuropathy, and the patient was closely followed up. Read More

Orthop Surg 2021 Mar 21. Epub 2021 Mar 21.

EMG Room, Tianjin Hospital, Tianjin, China.

Objective: To explore the effect of locating the ulnar nerve compression sites and guiding the small incision so as to decompress the ulnar nerve in situ on the elbow by high-frequency ultrasound before operation.

Methods: A retrospective analysis was conducted on 56 patients who underwent ultrasound-assisted in situ decompression for cubital tunnel syndrome from May 2018 to August 2019. The patients' average age was 51. Read More

Front Pharmacol 2020 5;11:621150. Epub 2021 Mar 5.

Division of Pharmacy Practice, Department of Pharmaceutical Care, School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand.

Peripheral nerve entrapment syndromes commonly result in pain, discomfort, and ensuing sensory and motor impairment. Many conservative measures have been proposed as treatment, local injection being one of those measures. Now with high-resolution ultrasound, anatomical details can be visualized allowing diagnosis and more accurate injection treatment. Read More

Br J Neurosurg 2021 Feb 27:1-9. Epub 2021 Feb 27.

Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China.

Background: Double crush syndrome (DCS) of the ulnar nerve, including cubital tunnel syndrome with ulnar tunnel syndrome (UTS), is uncommon. This study compares the postoperative outcomes of patients with isolated ulnar tunnel syndrome versus those with double crush syndrome of the elbow and ulnar tunnel.

Methods: This study enrolled 22 patients: 12 underwent cubital tunnel surgery and ulnar tunnel surgery (double crush group); and 10 underwent only ulnar tunnel decompression (isolated UTS group). Read More

Surgeon 2021 Feb 4. Epub 2021 Feb 4.

Department of Anatomy, Faculty of Science, Mahidol University, Bangkok, Thailand. Electronic address:

Background: Anconeus epitrochlaeris muscle and Osborne's ligament are anatomical variants that are occasionally found at the cubital tunnel of the elbow. In certain individuals, these two structures may compress the ulnar nerve resulting in a cubital tunnel syndrome. Although these variants have been reported extensively, its prevalence is still unclear and its contribution to cubital tunnel syndrome is debatable. Read More

Instr Course Lect 2021 ;70:73-84

The carpal and cubital tunnel syndromes are the most common compression neuropathies of the upper extremity. Although the diagnosis and management of these neuropathies have evolved over the past few decades, the ideal primary surgical treatment has not yet been established and management of recurrence remains a challenge. Revision surgery with simple repeated nerve decompression even accompanied by neurolysis does not always result in satisfactory clinical outcomes. Read More

Ann Transl Med 2020 Dec;8(23):1563

Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China.

Background: The first dorsal interosseous muscle (FDI) is usually innervated by the deep branch of the ulnar nerve. However, as was first noted by Sunderland in 1946, some individuals have variable innervation of the FDI. This study investigated the incidence of variable innervation of the FDI by using electrophysiological examination and further evaluated the relevance of this variation in patients with cubital tunnel syndrome (CuTS). Read More

J Hand Surg Eur Vol 2021 Mar 10;46(3):260-264. Epub 2021 Jan 10.

Pulvertaft Hand Centre, Derby, UK.

The relationship between surgery for cubital tunnel and carpal tunnel syndrome was examined in this retrospective study. Between 1997 and 2018, data from consecutive patients who underwent carpal tunnel release (8352 patients), cubital tunnel release (1681 patients) or both procedures (692 patients) were analysed. The relative risk of undergoing cubital tunnel release in the population who had carpal tunnel release compared with those with no carpal tunnel release was 15. Read More

Surg Radiol Anat 2021 May 9;43(5):713-720. Epub 2021 Jan 9.

Institute of Biomedical Research, Marcílio Dias Naval Hospital, Rio de Janeiro, Brazil.

Purpose: The cubital tunnel is limited anteriorly by the medial epicondyle (ME), laterally by the medial collateral ligament, and superiorly by Osborne's fascia and the cubital tunnel retinaculum. Previous studies were mostly dedicated to the roof of the cubital tunnel, in the way that the study of the groove for ulnar nerve and ME anatomy is relatively scarce in the literature. We sought to describe the radiological anatomy of the groove for ulnar nerve and ME in healthy volunteers with multiplanar computed tomography (CT). Read More

SAGE Open Med Case Rep 2020 18;8:2050313X20972850. Epub 2020 Dec 18.

Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan.

Cubital tunnel syndrome, the second-most common peripheral compression neuropathy, is associated with dynamic pressure in the cubital tunnel with the elbow flexion position. Medial elbow ganglion originated from the ulnohumeral joint causing cubital tunnel syndrome has been reported. This report describes the case of a 48-year-old man who developed numbness in his left ring and little finger after prolonged motorbike touring. Read More

J Orthop Surg (Hong Kong) 2021 Jan-Apr;29(1):2309499020982084

Department of Orthopaedic Surgery, 1065Flinders University, Adelaide, Australia.

Cubital tunnel syndrome is the second most common compressive neuropathy of the upper limb. Endoscopic cubital tunnel decompression has gained popularity in recent years as this enables surgeons to achieve decompression of the ulnar nerve along its course using a small incision. This article describes the technical peals in performing endoscopic cubital tunnel decompression. Read More

Muscle Nerve 2021 04 17;63(4):472-476. Epub 2021 Jan 17.

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.

Background: Precise placement of stimulating and recording electrodes is vital when performing nerve conduction studies (NCSs). In this study, we aimed to determine whether ultrasonography (US) was more precise in localizing the superficial radial nerve (SRN), dorsal ulnar cutaneous nerve (DUCN), ulnar nerve (UN) crossing the cubital tunnel, and radial nerve (RN) crossing the spiral groove (SG) compared to conventional techniques.

Methods: Thirty healthy young subjects (15 male) were recruited. Read More

J Hand Microsurg 2020 Oct 18;12(Suppl 1):S28-S32. Epub 2019 Nov 18.

Department of Orthopedics, Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, United States.

 The current understanding of revision rates following surgery for the primary surgical treatment of idiopathic cubital tunnel syndrome (CuTS) remains unclear. The purpose of this study was to describe and compare the rate of revision surgery following in situ decompression (SD) versus anterior transposition (AT) after the surgical treatment of idiopathic CuTS and examine possible predicting variables for revision.  A retrospective cohort study was performed at a single institution by querying records for all CuTS surgeries performed between January 2010 and December 2015. Read More

JAMA Netw Open 2020 11 2;3(11):e2024352. Epub 2020 Nov 2.

Department of Plastic and Reconstructive Surgery, Leeds Teaching Hospitals Trust, Leeds, United Kingdom.

Importance: Cubital tunnel syndrome is the second most common compressive neuropathy, affecting 6% of the population. Numerous different operations are performed globally to treat it; however, prior conventional (pairwise) meta-analyses have been unable to determine which procedure is associated with the best outcomes and fewest complications.

Objective: To evaluate which operation for cubital tunnel syndrome is associated with the greatest likelihood of symptomatic cure. Read More

Acta Ortop Mex 2020 Jan-Feb;34(1):31-37

Instituto Allende de Cirugía Reconstructiva. Córdoba, Argentina.

Introduction: Currently there is no universally accepted standard of reference for the diagnosis of carpal tunnel syndrome so it is considered a «latent class» pathology, that is, it lacks any diagnostic tests that absolutely certain the presence of disease.

Methods: Prospective, observational and analytical study evaluating the three diagnostic methods used for carpal tunnel syndrome (clinical examination, ultrasound and electromyography). Normality values were set for each diagnostic method. Read More

BMC Psychiatry 2020 11 17;20(1):540. Epub 2020 Nov 17.

Department of Hand Surgery, The Third hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei, China.

Background: The aim of this cross-sectional study to assess the proportions of anxiety and depression in patients with CuTS, and to explore the associated demographic and clinical features.

Methods: From May 2011 to January 2017, 246 patients diagnosed with CuTS were recruited. The Hospital Anxiety and Depression Scale was used to assess the proportions of depression and anxiety. Read More

Physiother Theory Pract 2020 Nov 6:1-6. Epub 2020 Nov 6.

Doctor of Physical Therapy Program, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA.

: Patients with ulnar neuropathy usually experience sensory disturbances, weakness, and decreased function; however, optimal treatment approaches for this condition are not conclusive.: A 48-year-old male with cubital tunnel syndrome was previously managed with a multimodal approach including splinting, neural mobilizations, and exercises with no change in symptoms. Approximately 1 year after the initial onset, he received three sessions of ultrasound-guided percutaneous electrical stimulation (PENS) and self-neural glides as a home program. Read More

J Hand Surg Eur Vol 2021 Jan 5;46(1):45-449. Epub 2020 Nov 5.

Department of Plastic Surgery, University Medical Centre Groningen, Groningen, The Netherlands.

The current evidence for treatment of primary idiopathic cubital tunnel syndrome favours an in situ release. However, anterior transposition of the ulnar nerve remains a popular procedure in recurrent cubital tunnel syndrome. For more than 20 years, I have performed an extended in situ release only, and achieved similar or better results than with nerve transposition. Read More

J Peripher Nerv Syst 2020 12 7;25(4):401-412. Epub 2020 Nov 7.

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

We performed a prospective multicenter case-control study to explore the association between ulnar neuropathy at elbow (UNE) and body and elbow anthropometric measures, demographic and lifestyle factors, and comorbidities. Cases and controls were consecutively enrolled among subjects admitted to four electromyography labs. UNE diagnosis was made on clinical and neurographic findings. Read More

J Hand Surg Asian Pac Vol 2020 Dec;25(4):393-401

Department of Orthopaedic Surgery, Royal Wolverhampton NHS Trust, Wolverhampton, UK.

Cubital tunnel syndrome is the second most common nerve compression syndrome seen in the upper limb. Paresthesia and weakness are the two most common presentations in the hand. If left untreated, compression can lead to irreversible nerve damage, resulting in a loss of function of the forearm and hand. Read More

Ultrasonography 2020 Aug 23. Epub 2020 Aug 23.

Department of Radiology, Chung-Ang University Hospital, Seoul, Korea.

Purpose: This study was designed to verify whether shear-wave elastography (SWE) can be used to differentiate ulnar neuropathy at the cubital tunnel from asymptomatic ulnar nerve or medial epicondylitis. An additional aim was to determine a cut-off value to identify patients with ulnar neuropathy.

Methods: This study included 10 patients with ulnar neuropathy at the cubital tunnel as confirmed with electromyography (three women and seven men; mean age, 51. Read More

Hand (N Y) 2020 Oct 19:1558944720963944. Epub 2020 Oct 19.

University of Michigan Health Systems, Ann Arbor, USA.

Controversy exists regarding the influence of breast cancer-related lymphedema (BCRL) in the development of peripheral neuropathies. Our aim was to evaluate the association of secondary lymphedema with peripheral neuropathies in patients with breast cancer. We performed a systematic review by querying PubMed, EMBASE, Ovid Medline and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, and Cochrane Central Register of Controlled Trials databases. Read More

Pol J Radiol 2020 21;85:e440-e460. Epub 2020 Aug 21.

Research Service, VA San Diego Healthcare System, San Diego, CA, USA.

Elbow pain can cause disability, especially in athletes, and is a common clinical complaint for both the general practitioner and the orthopaedic surgeon. Magnetic resonance imaging (MRI) is an excellent tool for the evaluation of joint pathology due to its high sensitivity as a result of high contrast resolution for soft tissues. This article aims to describe the normal imaging anatomy and biomechanics of the elbow, the most commonly used MRI protocols and techniques, and common MRI findings related to tendinopathy, ligamentous and osteochondral injuries, and instability of the elbow. Read More

Jt Dis Relat Surg 2020 ;31(3):523-531

Başkent Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, 06490 Bahçelievler, Ankara, Türkiye.

Objectives: This study aims to compare the clinical and functional outcomes of simple in-situ decompression and partial medial epicondylectomy for the treatment of idiopathic cubital tunnel syndrome (CuTS).

Patients And Methods: Between March 2014 and December 2016, 71 patients (31 males, 40 females; mean age 46.7 years; range, 38 to 62 years) with CuTS scheduled to undergo simple in-situ decompression (group 1) or partial medial epicondylectomy (group 2) were prospectively reviewed. Read More