Endoscopic cubital tunnel release: a systematic review

Area of Science:

• Orthopedic Surgery
• Neurosurgery
• Minimally Invasive Procedures

Background:

• Endoscopic cubital tunnel release presents theoretical benefits including a small incision, reduced nerve damage risk, and potentially quicker recovery.
• These advantages suggest an improved patient outcome compared to traditional surgical methods.

Purpose of the Study:

• To systematically review the existing literature on endoscopic cubital tunnel release.
• To evaluate the effectiveness, complications, and areas for future research in this surgical technique.

Main Methods:

• A systematic literature search was conducted across Medline (PubMed), Web of Science, and Scopus.
• Keywords included 'endoscopic ulnar nerve', 'endoscopic cubital nerve', 'endoscopic ulnar compression', and 'endoscopic ulnar neuropathy'.
• Twenty-one studies were included, and their methodological quality was assessed using the Coleman Methodological Score.

Main Results:

• Endoscopic release is effective for cubital tunnel entrapment, providing adequate visualization.
• Outcomes are negatively associated with compression severity.
• Injury to the medial antebrachial cutaneous nerve is less frequent; hematoma is the most common complication.

Conclusions:

• Endoscopic techniques offer advantages such as a shorter return-to-work time and improved scar appearance.
• Further randomized clinical trials with standardized scoring and longer follow-up are necessary.
• The role of ulnar nerve instability and the learning curve require additional investigation.