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Review
. 2021 Sep 14;6(9):735-742.
doi: 10.1302/2058-5241.6.200135. eCollection 2021 Sep.

The management of failed cubital tunnel decompression

Abdus S Burahee  1 , Andrew D Sanders  1 , Dominic M Power  1
Affiliations
Review

The management of failed cubital tunnel decompression

Abdus S Burahee et al. EFORT Open Rev. .

Abstract

Cubital tunnel decompression is a commonly performed operation with a much higher failure rate than carpal tunnel release.Failed cubital tunnel release generally occurs due to an inadequate decompression in the primary procedure, new symptoms due to an iatrogenic cause, or development of new areas of nerve irritation.Our preferred technique for failed release is revision circumferential neurolysis with medial epicondylectomy, as this eliminates strain, removes the risk of subluxation, and avoids the creation of secondary compression points.Adjuvant techniques including supercharging end-to-side nerve transfer and nerve wrapping show promise in improving the results of revision surgery.Limited quality research exists in this subject, compounded by the lack of consensus on diagnostic criteria, classification, and outcome assessment. Cite this article: EFORT Open Rev 2021;6:735-742. DOI: 10.1302/2058-5241.6.200135.

Keywords: compression neuropathy; failed cubital tunnel syndrome; ulnar nerve.

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Conflict of interest statement

ICMJE Conflict of interest statement: DMP reports receipt of faculty fees for lecturing and for leading workshops in peripheral nerve injury (including the use of the Axoguard for scarred nerves) from Axogen Inc., relating to the published work. The other authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Ulnar nerve tethered in scar tissue following previous subcutaneous anterior transposition.
Fig. 2
Fig. 2
Previous submuscular transposition with new compression points.
Fig. 3
Fig. 3
Decompressed ulnar nerve following medial epicondylectomy and repair of common flexor origin.
Fig. 4
Fig. 4
Ulnar nerve following medial epicondylectomy and wrapping.
Fig. 5
Fig. 5
Iatrogenic medial antebrachial cutaneous nerve neuromas secondary to primary cubital tunnel decompression.
Fig. 6
Fig. 6
Medial antebrachial cutaneous nerve neuromas treated with excision and capping.
See this image and copyright information in PMC

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