Sonographic Examination Cubital Tunnel Release

Sonographic Follow-up of Patients With Cubital Tunnel Syndrome (CTS) Undergoing Open Neurolysis in Situ or Endoscopic Release: A Prospective Study

The investigators want to compare changes in cross-sectional area (CSA) of the ulnar nerve at the elbow after open release or endoscopic release.

The investigators want to compare changes in CSA of the ulnar nerve at the elbow hypothesizing that US examination is a useful tool to detect unsuccessful release and defining which technique shows the best outcome in the first year postoperatively.

The measurement of cross-sectional area (CSA) as a diagnostic tool to detect entrapments syndrome in upper limbs has already been described. US typically demonstrates an abrupt narrowing and displacement of the nerve within the tunnel, possibly in association with a thickened retinaculum or a space-occupying lesions. Previous studies prospectively compared sonographic outcomes after decompression of the median nerve at the wrist.

Inclusion Criteria:

• history of paresthesia or numbness in the ulnar nerve distribution;
• weakness or wasting of the small muscles of the hand;
• a positive elbow flexion provocation test;
• slowed motor conduction velocity in the ulnar nerve below 50 m/sec.

Exclusion Criteria:

• Patients with normal nerve conduction studies;
• prior surgery for Cubital Tunnel Syndrome;
• prior traumatic lesions of the elbow;
• coexistent neurological diseases;
• bone anormalities (cubitus valgus, deformities from previous elbow fractures, osteoarthritis with medial osteophytes ands loose bodies, heterotopic ossifications);
• subluxating ulnar nerve;
• space-occupying soft-tissue lesions.