Challenging the dogma: anterior transposition of the ulnar nerve is indicated in recurrent cubital tunnel syndrome

Mike Ruettermann*

*Corresponding author for this work

    Research output: Contribution to journalReview articleAcademicpeer-review

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    Abstract

    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. In performing a systematic review of the evidence for surgery for recurrent cubital tunnel syndrome, I could only include 16 out of 296 studies regarding treatment of recurrent cases of cubital tunnel syndrome. A meta-analysis was not possible, due to selection bias and disparity of outcome measurements of the studies. However, I could not find robust evidence that supports the need of an anterior transposition of the ulnar nerve in recurrent cubital tunnel syndrome over an in situ decompression. My own experience of an extended in situ release with complete neurolysis with reasonable outcomes, in combination with the lack of literature support of anterior transposition in recurrent cases, have led me to the consideration that this dogma should be revised.

    Original languageEnglish
    Pages (from-to)45-49
    Number of pages5
    JournalJournal of Hand Surgery (European volume)
    Volume46
    Issue number1
    DOIs
    Publication statusPublished - Jan-2021

    Keywords

    • Cubital tunnel syndrome
    • ulnar nerve compression
    • recurrence
    • systematic review
    • dogma
    • anterior transposition
    • SUBMUSCULAR TRANSPOSITION
    • IN-SITU
    • SIMPLE DECOMPRESSION
    • REOPERATION
    • NEUROPATHY
    • NEUROLYSIS
    • ETIOLOGY
    • OUTCOMES
    • SURGERY
    • ELBOW

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