The Surgical Treatment of Ulnar Nerve Entrapment Neuropathy at the Elbow Level by Simple Decompression

Year 2010, Volume: 15 Issue: 4, 194 - 196, 01.08.2010

Cahit Kural Soner Yaşar İlker Solmaz Serhat Pusat Yusuf İzci

Abstract

Objective: Ulnar nerve entrapment neuropathy usually occurs at the cubital groove. The treatment is conservative approach or surgery. In this study, our aim is to evaluate the surgical results of simple decompression technique on the treatment of ulnar nerve entrapment neuropathy. Materials and Methods: Fifty-six patients with the diagnosis of ulnar nerve entrapment neuropathy were operated between 2005 and 2009. The ulnar nerve was intact in all cases. Thirty-six patients were male and 20 were female. The mean age was 37.8 years. Simple decompression at the elbow level was performed in all patients under the local anesthesia. The mean operation duration was 30 minutes. Results: The complaints were totally improved in 92.86% of the patients. Four patients did not benefit from the surgery and 3 of them had rheumatological disease. No complication was observed and the complaints were not increased in any case. Conclusion: Simple decompression at the elbow level is the most appropriate and less invasive method in the treatment of ulnar nerve entrapment neuropathy. Surgical treatment must be delayed in patients with rheumatological disease.

Keywords

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Ulnar Sinirin Kubital Oluk Düzeyinde Tuzak Nöropatisinin Basit Dekompresyon Yöntemi İle Cerrahi Tedavisi

Abstract

Amaç: Ulnar sinir tuzak nöropatisi (TNP) genellikle kubital oluk seviyesinde meydana gelir. Tedavisi konservatif yaklaşım veya cerrahidir. Bu çalışmadaki amacımız ulnar TNP'de uyguladığımız basit dekompresyon tekniğinin cerrahi sonuçlarını incelemektir. Gereç ve Yöntemler: 2005-2009 arasında ulnar TNP tanısı alan 56 hasta kliniğimizde opere edildi. Bu hastaların tamamının sinir bütünlüğü tam idi. Hastaların 36'sı erkek, 20'u ise bayan idi. Yaş ortalaması 37,8 idi. Hastaların tümüne lokal anestezi altında kubital oluk düzeyinde basit dekompresyon ameliyatı uygulandı. Ortalama ameliyat süresi 30 dk. olarak kaydedildi. Bulgular: Hastaların %92,86‘sinin şikayetleri ameliyattan sonra tamamen geçti. 56 hastanın 4'ü cerrahiden fayda görmedi, bu hastaların 3'ü romatolojik hastalığı bulunan kişilerdi. Hiçbir hastada cerrahi komplikasyon gelişmedi ve hastaların şikayetleri ameliyattan sonra artmadı. Sonuç: Basit dekompresyon ulnar sinirin kubital oluk seviyesindeki TNP'inde en uygun ve en az invazif cerrahi yöntemdir. Eşlik eden romatolojik hastalığı olanlarda cerrahi için beklenmelidir.

Keywords

Ulnar sinir tuzak nöropatisi, kubital oluk, basit dekompresyon

References

• Bradshaw DY, Shefner JM. Ulnar neuropathy at the elbow. Neurol Clin 1999; 17: 447-461.
• Heithoff SJ. Cubital tunnel syndrome does not require transposition of the ulnar nerve. J Hand Surg Am. 1999; 24: 898-905.
• Huang JH, Samadani U, Zager EL. Ulnar nerve entrapment neuropathy at the elbow: simple decompression. Neurosurgery. 2004; 55: 1150-1153.
• Wilson DH, Krout R. Surgery of ulnar neuropathy at the elbow: 16 cases treated by decompression without transposition- technical note. J Neurosurg. 1973; 38: 780-785.
• Bartels RH, Termeer EH, van der Wilt GJ, et al. Simple decompression or anterior subcutaneous transposition for ulnar neuropathy at the elbow: a cost-minimization analysis-part 2. Neurosurgery. 2005; 56: 531-536.
• Collier A and Burge P. Management of mechanical neuropathy of the ulnar nerve et elbow. Current Orthopedics 2001; 15: 256- 263.
• Lowe III JB, Novak CB, Mackinnon SE. Current approach to cubital tunnel syndrome. In: Neurosurgery Clinics of North America. Vol. 12, 2001: 267-284.
• Mc Gillicudy JE, Sullivian SE. Entrapment/compression Neuropathies. In Textbook of Neurological Surgery. Batcher HH and Loftus CM(eds). Vol: 3. Chap.214.Philadelphia: Lippincott- William Wilkins, 2003: 2001-2238.
• Oertel J, Keiner D, R. Gaab M. Endoscopic decompression of the ulnar nerve at the elbow: Neurosurgery 2010; 66: 817-824.
• Hoffmann R, Siemionow M. The endoscopic management of cubital tunnel syndrome. J Hand Surg Br. 2006; 31: 23-29.
• Bartels RH, Verhagen WI, van der Wilt GJ, Meulstee J, van Rossum LG, Grotenhuis JA. Prospective randomized controlled study comparing simple decompression versus anterior subcutaneous transposition for idiopathic neuropathy of the ulnar nerve at the elbow: part 1. Neurosurgery. 2005; 56: 522-530.
• Oertel J, Horn J, Schroeder HW, Gaab MR. Surgery of the ulnar-nerve entrapment syndrome: neurolysis versus ventral submuscular transposition. In: Steudel WI, ed. Abstract book: 54. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie 2003. Aachen, Germany: Shaker, pp: 139.
• Dellon AL. Review of treatment results for ulnar nerve entrapment at the elbow. J Hand Surg (Am) 1989; 14: 688-700.
• Mowlavi A, Andrews K, Lille S, Verhulst S, Zook EG, Milner S. The management of cubital tunnel syndrome: a meta-analysis of clinical studies. Plast Reconst Surg. 2000; 106: 327-334.
• Kabul Tarihi: Kabul Tarihi: 08.10.2010