Minimally invasive release of the cubital tunnel

Abstract

Entrapment of the ulnar nerve that leads to cubital tunnel syndrome is a common and often disabling disease. Current surgical treatment options involve simple decompression, medial epicondylectomy, or a variety of anterior transposition procedures. Such techniques often involve extensive exposure of the ulnar nerve with prolonged periods of immobilization. Because of this, patients may often experience significant postoperative pain, scarring, and joint stiffness. In this paper, we describe a minimally invasive technique for treating cubital tunnel syndrome using endoscopic assistance. This procedure enables complete ulnar nerve decompression through one small incision. Direct visualization of all potential anatomic compression sites for a distance of 20 cm around the medial epicondyle is possible. This endoscopic approach to cubital tunnel release is appealing, especially to those patients with mild to moderate symptoms who may otherwise be reluctant to undergo a more involved conventional surgery. It decreases postoperative pain, reduces scarring, and promotes an earlier return to activity than traditional open techniques allow, due to a decreased immobilization period.