Ulnar Nerve in Situ Decompression versus Transposition for Idiopathic Cubital Tunnel Syndrome: Long-term clinical outcome: Multicenteric retrospective study

BACKGROUND: Cubital tunnel syndrome is one of the most frequent upper extremity entrapment neuropathies. The best surgical therapy for cubital tunnel syndrome remains controversial and a topic of discussion. OBJECTIVE: Our goal is to compare the results of two different surgical approaches for cubital tunnel syndrome and to correlate the preoperative findings guided by electrodiagnostic studies with the intraoperative findings regarding the accurate sites of ulnar nerve compression at the cubital tunnel in both surgical approaches, as well as to assess the long-term clinical outcome of surgical management. AND METHODS: the of two different To confirm the diagnosis and locate locations of in electrodiagnostic were Preoperative clinical symptoms were identified using Dellon’s staging approach, and postoperative clinical outcome was assessed using a modified Bishop rating system in all patients. RESULTS: The outcomes were graded excellent in 61 patients, good in 15 patients, and fair in three patients. Regarding the in situ group, excellent improvement was obtained in 30 patients (78.9%), good improvement in 6 patients (15.8%) and fair improvement in 2 patients (5.3%). Regarding the transposition group, excellent improvement was achieved in 31 patients (75.6%), whereas good improvement and fair improvement were observed in 9 patients (21.9%) and 1 (2.4%) patient, respectively. Electrodiagnostic studies were not accurate in detecting the actual sites of ulnar nerve entrapment, while intraoperative results were more accurate. CONCLUSION: In situ decompression is as beneficial as anterior transposition in the treatment of cubital tunnel syndrome, according to our findings. When compared to intraoperative results, electrodiagnostic investigations perform poorly in diagnosing the precise locations of ulnar nerve compression.