The treatment of the cubital tunnel syndrome

Treatment by in situ release, submuscular transposition, and anterior subcutaneous transposition have all been reported to produce satisfactory results for ulnar neuropathy secondary to the cubital tunnel syndrome. A prospective study was done to determine which preoperative clinical and electrical factors and surgical approaches in patients with ulnar nerve palsy at the elbow had the best results. The 32 patients had an average age of 50 years, had symptoms for an average of 15 months before surgery, and underwent postoperative follow-up for an average of 13 months. All patients with good results had no atrophy or preoperative fibrillations in the intrinsic muscles and had an obtainable evoked sensory potential. The change in motor conduction velocity did not correlate with good results. There was no significant difference in the results of the three surgical procedures. Eight of the 37 operations yielded good results, 19 patients showed an improvement, but 10 of the operations yielded poor results. Our results also indicated that surgical results could be predicted by proper patient selection through the assessment of the preoperative physical examination and electromyogram.