Related Experiment Video
Updated: May 1, 2026
Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
[Cubital tunnel syndrome and the scratch test to determine the surgical procedure]
Background:
Neuropathy due to ulnar nerve compression at the elbow level is the second most frequent neuropathy. The scratch collapse test is useful to diagnose compression neuropathies. This test helps us rank compression sites and decide the type of treatment to use.
Methods:
From May to July 2011, 34 patients, mostly females, were preoperatively analyzed with this test. Ethyl chloride was also used to show other compression sites.
Results:
The main compression site was found to be at the level of Osborne's ligament, contrary to the idea that it was located at the medial epicondyle. Another finding was that at the hand and wrist level it is more common to find compression in the proximal fascia of the forearm than in Guyon's canal. After surgery, CRP became negative in all patients.
Discussion And Conclusions:
When the primary collapse point is Osborne's ligament, the patient will require ulnar nerve transposition. When the primary collapse point is located at the level of the medial epicondyle, decompression is enough. In case of several simultaneous collapse points before applying ethyl chloride, a surgical procedure will not necessarily be required for each one of them.
