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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
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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.

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.