FESSH prep Compressive neuropathies Cubital tunnel syndrome — surgical management and outcomes
Surgical Outcomes of Ulnar Nerve Decompression
Surgical Outcomes of Ulnar Nerve Decompression
1.When the ulnar nerve is stable in flexion, in situ decompression and anterior transposition produce equivalent clinical outcomes, with simple decompression preferred because of lower operative morbidity.
2.When dynamic, symptomatic subluxation of the ulnar nerve over the medial epicondyle is demonstrated, anterior transposition (or medial epicondylectomy) is preferred over in situ decompression.
3.Compared with anterior transposition, medial epicondylectomy avoids extensive nerve mobilisation and preserves the segmental blood supply of the ulnar nerve; the procedure carries a theoretical risk of medial elbow instability if too much bone is removed.
4.Postoperative grip strength typically recovers within two weeks after cubital tunnel decompression.
5.Preoperative compound muscle action potential (CMAP) amplitude is a useful predictor of recovery after ulnar nerve decompression.
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