Comparison of two medial epicondylectomy techniques in cubital tunnel syndrome
Meriç Çırpar1, Cem Seyfi Özüak2, Birhan Oktaş1, İbrahim Deniz Canbeyli1
1Department of Orthopedics and Traumatology, Medical Faculty of Kırıkkale University, Kırıkkale, Turkey
2Department of Orthopedics and Traumatology, Niksar State Hospital, Tokat, Turkey
Keywords: Cubital tunnel; medial epicondylectomy; ulnar nerve.
Abstract
Objectives: This study aims to compare partial medial epicondylectomy (PMe) and distal medial epicondylectomy (DMe) techniques in terms of sensory and motor improvements, functional results and complications.
Patients and methods: The study included a total of 59 cubital tunnel syndrome patients (37 males, 22 females; mean age 42.3 years; range 23 to 80 years). Of the patients, DMe was applied on 30 and PMe was applied on 29. Patients were evaluated with Wilson Krout scores, Semmes-Weinstein Monofilament (SWM) test, and grip and pinch strength measurements preoperatively and at postoperative third, sixth, and 12th months. Both groups’ pre- and postoperative intragroup and intergroup results were compared.
Results: Wilson Krout scores in postoperative checks were better with DMe compared to PMe. The improvement in SWM test scores was statistically significant for only DMe. The improvement in grip strength, lateral pinch and terminal pinch measurements in DMe group was significant at postoperative third month. In PMe group, significant improvement for these measurements was obtained at postoperative sixth month. The only complication observed with DMe was tenderness developing over the medial epicondyle. Painful subluxation of the nerve associated with paresthesia was detected in four patients in PMe group.
Conclusion: Compared to PMe, DMe offers more satisfactory subjective results. Motor functional recovery occurs earlier with DMe. DMe appears to have lower complication rates.