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Visualization During Endoscopic Versus Open Cubital Tunnel Decompression: A Cadaveric Study.

Joseph Said1, Kaela Frizzell2, Juliana Heimur3

  • 1Department of Orthopaedic Surgery, Division of Hand Surgery, Rothman Institute, Jefferson Medical College, Philadelphia, PA.

The Journal of Hand Surgery
|November 14, 2018
PubMed
Summary
This summary is machine-generated.

A 4-cm open incision provides visualization equivalent to the 2-cm endoscopic cubital tunnel release. Further increasing the open incision to 6 cm offers statistically significant improvements in visualization.

Keywords:
Cubital tunnelendoscopic cubital tunnel decompressionminimally invasive

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Area of Science:

  • Orthopedic Surgery
  • Surgical Techniques
  • Anatomy

Background:

  • Cubital tunnel syndrome is a common condition caused by ulnar nerve compression at the elbow.
  • Endoscopic cubital tunnel release is a minimally invasive technique, but visualization can be limited.
  • Open cubital tunnel release offers potentially better visualization but requires a larger incision.

Purpose of the Study:

  • To determine the minimum incision size for open cubital tunnel release that provides visualization comparable to endoscopic techniques.
  • To compare the visualization extent between open and endoscopic cubital tunnel release methods.

Main Methods:

  • Ten fresh-frozen cadavers were used to assess visualization.
  • An endoscopic system with percutaneous needle localization was employed initially.
  • Open cubital tunnel release was performed with incrementally increasing incision sizes (2 cm, 4 cm, 6 cm) to record visualization extents.

Main Results:

  • The endoscopic technique provided a mean visualization of 8.1 cm proximally and 8.3 cm distally.
  • A 2-cm open incision yielded significantly less visualization (5.9 cm proximal, 5.2 cm distal) compared to the endoscopic method.
  • A 4-cm open incision achieved visualization equivalent to the endoscopic technique, while a 6-cm incision provided statistically significant improvement.

Conclusions:

  • A 4-cm open incision is sufficient to achieve visualization comparable to the 2-cm endoscopic cubital tunnel release.
  • While endoscopic release offers better visualization with smaller incisions, its impact on surgical decompression efficacy remains uncertain.