Cubital tunnel release with medial epicondylectomy factors influencing the outcome.

From 347 cases of documented cubital tunnel syndrome, 160 required cubital tunnel release and medial epicondylectomy over a 10-year period and were considered for this retrospective study. These patients were monitored for 3 years after surgery. According to the modified scale of McGowan, 86% of patients were considered stage II. Eighty-one percent of the patients were symptom free, and 96% of the patients improved by 1 Wilson and Krout grade following surgery. We considered return of symptoms 3 months or longer after surgery as recurrence; there were 21 recurrences. There was no correlation between recurrence and limb dominance, patient age at the time of surgery, or length of preoperative conservative treatment. Of the patients with recurrences, 44% were in their fourth decade of life. The rate of recurrence in females (18%) was almost twice that in males (10%). The rate of recurrence was increased twofold when the patient did not return to work within 3 months. When concomitant ipsilateral carpal tunnel was present (44%), the recurrence rate was 17% compared with 9% in those without carpal tunnel syndrome. The recurrence rate was 20% when ipsilateral thoracic outlet syndrome was present compared with 9% in patients without other ipsilateral maladies. Therefore, higher recurrence rates should be anticipated in female patients, in patients with concomitant ipsilateral thoracic outlet syndrome and/or carpal tunnel syndrome, in patients in their third or fourth decade of life, or in patients not returning to work within 3 months after surgery.