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Endoscopic cubital tunnel release using the Hoffmann technique.

Reimer Hoffmann1, John Lubahn

  • 1Institut für Handchirurgie und Plastische Chirurgie Oldenburg (HPC Oldenburg) Oldenburg, Germany; and UPMC Hamot, Erie, PA 16507, USA.

The Journal of Hand Surgery
|May 28, 2013
PubMed
Summary

This study details an endoscopic cubital tunnel release technique for ulnar nerve decompression. The method allows for extensive visualization and release of constricting tissues around the nerve.

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Area of Science:

  • Orthopedic Surgery
  • Neurosurgery
  • Minimally Invasive Procedures

Background:

  • Cubital tunnel syndrome is caused by ulnar nerve compression at the elbow.
  • Previous endoscopic techniques exist, but a modified approach offers distinct advantages.
  • The arcuate (Osborne's) ligament is a common site of ulnar nerve entrapment.

Purpose of the Study:

  • To describe a modified endoscopic technique for cubital tunnel release.
  • To detail the surgical steps and visualization capabilities of the Hoffmann and Siemionow technique.
  • To discuss the indications, contraindications, and outcomes of this endoscopic approach.

Main Methods:

  • A modified endoscopic cubital tunnel release technique is presented.
  • The procedure involves an incision similar to in situ release, allowing direct visualization.

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  • A soft tissue endoscope is used to decompress the ulnar nerve proximally and distally to the arcuate ligament.

    • Main Results:

    • The technique allows for exploration and decompression of the ulnar nerve over a 10 cm segment.
    • Direct visualization and release of compressive forearm fasciae and fibrous bands are achieved.
    • The procedure utilizes an endoscope, illuminated speculum, and specialized instruments for visualization and dissection.

    Conclusions:

    • The described endoscopic cubital tunnel release offers a viable alternative for ulnar nerve decompression.
    • This technique provides extensive visualization and decompression of the ulnar nerve.
    • Further discussion on indications, contraindications, and postoperative management is provided.