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The Surgical Approach to a Medial Epicondylectomy in Cubital Tunnel Syndrome
Abdus S Burahee1,2,3, Liron S Duraku2,3, Rajive Jose1
1From the The Peripheral Nerve Injury Service, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
Abstract:
Cubital tunnel syndrome, a common neuropathy of the upper limb, presents with sensory and motor symptoms, impacting hand function and grip strength. Surgical interventions, such as medial epicondylectomy (ME), aim to alleviate symptoms by relieving pressure on the ulnar nerve at the elbow. Historical attempts to treat this condition date back to the early 19th century, with procedures evolving over time. Modern techniques, including in situ decompression, transposition, and various forms of epicondylectomy, offer different approaches to address nerve compression. This article examined the evolution of ME techniques, highlighting the shift toward anatomical landmark-based referencing for precise osteotomy. Notably, adherence to consistent landmarks such as the ulnar collateral ligament and medial intermuscular septum ensures reproducibility and safety in surgical practice. Through meticulous dissection and osteotomy, ME aims to create a clear pathway for the ulnar nerve, reducing tension and preventing postoperative complications such as symptomatic nerve subluxation. Surgical success relies on thorough preoperative evaluation, precise technique execution, and attentive postoperative care. Complications, including nerve injury and joint instability, underscore the importance of surgical precision and patient monitoring. By prioritizing anatomical landmarks and using meticulous technique, ME offers a reliable solution for cubital tunnel syndrome, providing patients with improved function and symptom relief.
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