Cubital Tunnel Syndrome – Endoscopic-Assisted Anterior Submuscular Transposition of the Ulnar Nerve: A Feasibility Study Using a Cadaver Model

Abstract

The purpose of this project was to perform endoscopic-assisted release of the ulnar nerve with submuscular transposition using a single 4 cm incision at the cubital tunnel level in fresh cadaver limbs. A successful cubital tunnel release decompression depends on the precise release of all potential entrapment points. Twelve fresh cadaver limbs (from six human cadavers) were used for this project. A 4 cm incision was made along the course of the ulnar nerve at the cubital tunnel. While the ulnar nerve was under constant magnified visualization and protection, all surrounding fascial tissues were released freely from the nerve. The medial intermuscular septum and arcade of Struthers were adequately visualized and divided. The overlying superficial fascia of flexor carpi ulnaris being dissected freely from the nerve, the nerve was transposed and repair of the flexor aponeurosis to the medial epicondyle was completed. Release of the ulnar nerve with submuscular transposition was accessible through one small skin incision with the aid of the endoscope. This new procedure may have clinical applications with a surgical outcome similar to the traditional approach. This technique prevents long scarring, decreases patient postoperative pain and shortens the rehabilitation period.