Entrapment neuropathy at the cubital tunnel: simple decompression is the method of choice

We present a retrospective study of 41 patients treated by simple decompression for ulnar neuropathy. Pre- and postoperatively, patients were evaluated clinically and electrophysiologically. The median follow-up was 2 years (minimum: 0.5 years, maximum: 5.1 years). The leading pre-operative sign was motor loss in the ulnar distribution (36 patients = 89%) with consecutive atrophy of ulnar innervated muscles (30 patients = 75%). The secondary complaint was sensory impairment in 59% of all cases, less frequently patients presented with pain or paraesthesia. In the majority of cases the aetiology remained unknown (27 patients = 65%). When aetiology was known, previous trauma to the elbow was reported most frequently (9 patients = 22%). Motor nerve conduction velocity (mNCV), compared to the contralateral, non-involved arm, was lower at least for 10 m/s. In cases with atrophy of the ulnar innervated muscles the difference was greater than 15 m/s. In 89%, postoperative results were good or even very good. In 8% (3 patients) no improvement was observed. Worsening due to surgery did not occur. We could demonstrate a significant increase in postoperative mNCV of 7.95 m/s in all patients (p < 0.05). There is still disagreement as to the correct surgical treatment of this disorder. We favour simple decompression (SD) as the appropriate operative technique for cubital tunnel syndrome.