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Simple ulnar nerve decompression at the cubital tunnel
75%
2541/3378
Ulnar nerve decompression at the cubital tunnel with anterior submuscular transposition
12%
409/3378
Ulnar nerve decompression at the cubital tunnel with anterior subcutaneous transposition
11%
383/3378
Open carpal tunnel release
1%
23/3378
Endoscopic carpal tunnel release
0%
4/3378
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The patient's clinical presentation and physical exam are consistent with cubital tunnel syndrome. Simple decompression of the ulnar nerve is less invasive and achieves clinical outcomes equivalent to decompression with transposition. Zlowodzki et al conducted a meta-analysis evaluating anterior transposition and simple decompression of the ulnar nerve. No difference in motor nerve-conduction velocities or clinical outcome scores was found. Bartels performed a prospective randomized trial (included in the Zlowodski meta-analysis) on 152 patients comparing simple decompression to transposition. No difference in clinical results at 1 year were reported, but a significantly higher complication rate occurred in the transposition group (31%) compared to simple decompression (9.6%). Nabhan et al performed a level 1 study randomizing 66 patients to simple decompression or subcutaneous ulnar nerve transposition. No differences were found with respect to clinical outcome or nerve conduction velocities. The clinical photograph in Illustration A demonstrates Froment's sign; compensatory IP hyperflexion of FPL (AIN) to compensate for the loss of adductor pollicis (ulnar nerve) during key pinch.
2.9
(31)
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