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. 2022:8:40.
doi: 10.1051/sicotj/2022041. Epub 2022 Sep 26.

Percutaneous ultrasound-guided ulnar nerve release technique compared to open technique: A cadaveric study

Jad Mansour  1 , Joe Ghanimeh  2 , Abdelhamid Ghersi  1 , Berenice Moutinot  1 , Remy Coulomb  1 , Pascal Kouyoumdjian  1 , Olivier Mares  1
Affiliations

Percutaneous ultrasound-guided ulnar nerve release technique compared to open technique: A cadaveric study

Jad Mansour et al. SICOT J. 2022.

Abstract

Objectives: To evaluate the outcomes of a novel percutaneous ultrasound-guided technique for release of ulnar nerve entrapment at the elbow when compared to standard open release Methods: One single surgeon performed an ultrasound-guided percutaneous release of the cubital tunnel on a group of five cadaveric elbows and open release on five others. All procedures were timed, and incision lengths were recorded. Meticulous anatomic dissection was then performed to assess the complete release of the carpal tunnel and iatrogenic injuries.

Results: No significant difference was found between the two groups in terms of complete release and iatrogenic injury, whereas Operative time was significantly shorter for the US-guided technique. Incomplete releases of the nerve were found only during the first two trials in each group, while the third, fourth, and fifth trials showed a complete ulnar nerve release in both series, highlighting a fast learning curve for both techniques. All of this through a significantly smaller incision in the US-guided technique.

Conclusions: This study highlights the similar effects of these two techniques in terms of complete release of the ulnar nerve, with no clear superiority of one over the other in terms of morbidity rate. Both have a fast learning curve for an ultrasound-trained surgeon, with the US-guided technique being a less traumatic and quicker alternative procedure.

Keywords: Cadaveric; Ulnar nerve release; Ultrasound-guided ulnar nerve release – Cubital tunnel.

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Figures

Figure 1
Figure 1
Schematic view of the medial elbow with possible sites of ulnar nerve compression (in red rectangles). At the bottom left, the release rate represents the percentage of the colored area’s length that was found to be sectioned upon dissection.
Figure 2
Figure 2
(a) Example of Kemis knives: on the left, the Kemis H3 blade used in the present study. On the right, the Kemis H1 blade can be used for treatment of trigger fingers or De Quervain tenosynovitis. (b) Illustration of the Kemis knife as used to transect Osborne’s ligament.
Figure 3
Figure 3
A transverse sonogram showing the compression site of ulnar nerve at medial elbow.
Figure 4
Figure 4
Incision of the open technique.
Figure 5
Figure 5
Sites of ulnar nerve compression.
See this image and copyright information in PMC

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