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. 2026 Feb 23.
doi: 10.1097/PRS.0000000000012946. Online ahead of print.

Super-Turbocharged End-to-Side Nerve Transfer for Severe Cubital Tunnel Syndrome: Preliminary Results

Yu Si  1   2 , Hui Chen  1   2 , Ainizier Yalikun  1   2 , Wengbo Yang  3 , Qiyue Zhang  1   2 , Aierken Rehemutula  1   2 , Hongyu Zhou  1   2 , Jie Song  1   4   5   6   7   8 , Li Li  1   2
Affiliations

Super-Turbocharged End-to-Side Nerve Transfer for Severe Cubital Tunnel Syndrome: Preliminary Results

Yu Si et al. Plast Reconstr Surg. .

Abstract

Background: Severe cubital tunnel syndrome (CuTS) is a common peripheral nerve compression disorder. Recent literature suggests that super-turbocharged end-to-side nerve transfer (STETS), which adds a transfer from the abductor digiti minimi (ADM) branch, may further enhance the recovery of intrinsic muscle function. This study aimed to evaluate the clinical efficacy of STETS for severe CuTS and compare its outcomes with those of SETS, particularly in restoring intrinsic hand motor function.

Methods: This retrospective study included 14 patients with severe CuTS who underwent STETS and 10 who underwent SETS between January 2022 and August 2023. Ulnar nerve function was evaluated at 3 months, 12 months, and over 18 months postoperatively using the modified McGowan grading system, QuickDASH score, electromyography, two-point discrimination and manual muscle testing. Comparative analyses were performed between the two groups at each time point.

Results: The final analysis included 24 patients (mean age 56.88 ± 10.98 years) with at least 18 months of follow-up. At over 18 months postoperatively, both groups showed significant improvement in the QuickDASH score, first dorsal interosseous muscle strength and ulnar nerve conduction velocity at the elbow compared to preoperative values (p < 0.05). The pinch strength in both groups improved compared with the preoperative values, and no significant difference was observed between the groups (p > 0.05).

Conclusion: STETS demonstrated a non-inferior trend compared with SETS in several functional outcomes, but without statistically significant differences. Its definitive efficacy requires further validation through large-sample, prospective controlled studies.Clinical Relevance Statement: This study directly compares the STETS and SETS nerve transfer techniques and provides evidence that STETS demonstrated a non-inferior trend compared with SETS in several functional outcomes. These findings support the use of STETS as an effective surgical option for improving motor outcomes in patients with severe cubital tunnel syndrome.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Keywords: STETS; Severe cubital tunnel syndrome; anterior interosseous nerve; motor branch of the ulnar nerve; nerve transfer.

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Conflict of interest statement

Conflict of Interest Statement: The authors declare that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper.