Open Versus Endoscopische Cubital Tunnel Release

Abstract

Cubital tunnel syndrome is a symptomatic ulnar nerve dysfunction at the elbow region probably caused by a combination of compression, traction and friction. Static and dynamic factors are involved, leading to ischemia or mechanical compression, secondary to repeated elbow flexion, anatomic variants of muscles and ulnar nerve subluxation. It is the second most common form of nerve entrapment after carpal tunnel syndrome [1]. Several surgical techniques exist for treatment of cubital tunnel syndrome. Endoscopic cubital tunnel release has been reported as a promising minimally invasive technique. This chapter aims to compare outcomes and complications of open cubital tunnel release (OCTR) and endoscopic tunnel release (ECTR) in the treatment of idiopathic cubital tunnel syndrome. Methods: A systematic review of the literature was performed. Studies including adults with idiopathic cubital tunnel treated exclusively by ECTR or OCTR were included. Outcomes of interest were postoperative clinical outcome, satisfaction, pain, ability to work and complications. Postoperative clinical outcomes were dichotomized into 2 categories: improved or not improved. Results: 6 studies met the inclusion criteria (1 RCT and 5 observational), representing 156 open and 247 endoscopic decompressions. In the open group, 79% experienced improvement of clinical symptoms with 16% complication rate. In the endoscopic group, 86% experienced clinical improvement with 8% complication rate. No statistical significant differences were found for satisfaction and pain scores and ability to work. Conclusions: This review demonstrates similar effectiveness between the endoscopic (ECTR) and open (OCTR) techniques for treatment of idiopathic cubital tunnel syndrome with similar clinical outcomes and complication profiles. Keywords: compression neuropathy, cubital tunnel, endoscopic, ulnar nerve.