Ultrasound-guided Percutaneous Ulnar Nerve Release at the Elbow: A Stepwise Approach

Area of Science:

• Orthopedics
• Neurology
• Minimally Invasive Surgery

Background:

• Cubital tunnel syndrome is a common upper limb compressive neuropathy.
• Various surgical techniques exist, including open and endoscopic approaches.
• Ultrasound-guided release presents a minimally invasive alternative, but adoption is limited by concerns.

Purpose of the Study:

• To define indications for ultrasound-guided cubital tunnel release.
• To provide a reproducible, stepwise description of the technique.
• To evaluate the efficacy and safety of this minimally invasive approach.

Main Methods:

• Ultrasound-guided cubital tunnel release was performed on 22 patients meeting inclusion criteria.
• A step-by-step technique description and surgical video were provided.
• Clinical outcomes and complications were assessed postoperatively.

Main Results:

• 95% of patients achieved clinical improvement, with a mean modified Bishop score of 8.75.
• One patient had persistent paresthesia, and two experienced symptom recurrence.
• No major complications like nerve injury or infection were reported; one instance of ulnar nerve instability occurred.

Conclusions:

• Ultrasound-guided cubital tunnel release is a feasible and effective minimally invasive treatment for cubital tunnel syndrome.
• Careful patient selection and adherence to technical pearls can enhance surgical outcomes.
• This technique offers a safe alternative with a low complication rate, facilitating learning through provided resources.