[Efficacy comparison between anterior subcutaneous and submuscular transposition of ulnar nerve to treat cubital tunnel syndrome].

OBJECTIVE

To evaluate and compare the efficacy of anterior subcutaneous and submuscular transposition of the ulnar nerve in treating cubital tunnel syndrome.

METHODS

From August 2006 to August 2008, 66 patients with cubital tunnel syndrome were treated with anterior subcutaneous transposition (subcutaneous group, 24 cases) and with anterior submuscular transposition (submuscular group, 42 cases). According to McGowan stages, all patients were at Stage 2 or 3 entrapment neuropathy with paresthesia in the ring and small fingers. Respectively, 3 cases and 8 cases complicated by interosseous muscle atrophy in subcutaneous group and in submuscular group. No significant difference was found in gender, age, duration of the disease, and complication between two groups (P < 0.05). The surgical features, distribution of Bishop rates, two-point discrimination test, muscular strength, and complications were recorded.

RESULTS

The operation time was (28.4 +/- 5.2) minutes in subcutaneous group and (43.8 +/- 5.6) minutes in submuscular group, showing significant difference (P < 0.01). The incision length was (12.2 +/- 2.5) cm in subcutaneous group and (13.6 +/- 2.8) cm in submuscular group, showing significant difference (P < 0.05). All patients were followed up 1-3 years. According to Bishop scoring system, the results were excellent in 18 cases, good in 4 cases, and poor in 2 cases in subcutaneous group; excellent in 36 cases, good in 3 cases, and poor in 3 cases in submuscular group; and showing no significant difference between two groups (P > 0.05). At 6 months postoperatively, two-point discrimination and grip strength were improved when compared with that of preoperation (P < 0.05), but there was no significant difference between two groups (P > 0.05). Pain and dysesthesia of the scar were noted in 1 patient of the subcutaneous group and 3 patients of the submuscular group. No infection or hematoma was found and no patient needed reoperation.

CONCLUSION

Both operative methods are effective alternative for treating cubital tunnel syndrome. The anterior subcutaneous anterior transposition of the ulnar nerve has fewer traumas, and it is a better choice for some old patients.