versão On-line ISSN 2309-8309
versão impressa ISSN 1681-150X
SA orthop. j. vol.8 no.1 Pretoria Jan. 2009
Y RamguthyI; M CaridesII
IBMedSc(UDW), MBChB (Medunsa); Orthopaedic Registrar*
IIMBBCh(Rand), DipPEC(SA), FCS(SA)Orth; Senior Consultant, Department of Orthopaedics, University of the Witwatersrand
BACKGROUND: The procedure of choice in the surgical treatment of cubital tunnel syndrome remains controversial. The aim of this study is to report the results of simple decompression and decompression with anterior subcutaneous transposition.
METHODS: A retrospective review (July 2002-January 2007) using the Bishop Score to assess outcome. A total of 102 procedures (91 patients, 11 bilateral) were performed with a minimum of 9 months' post-operative follow-up. The procedure was selected intra-operatively. All cases were operated by the senior author (MC).
RESULTS: In the simple decompression group (n=47, average age 45.9 years), the average Bishop Score was 11.3 (5-13) with an average time to recovery of 3.7 months (1-6). Good to excellent results were obtained in 94% and fair results in 6%.
In the anterior transposition group (n=55, average age 43.3 years) the average Bishop Score was 10.6 (5-13) with average time to recovery of 4.2 months (1-6). Good to excellent results were obtained in 93% and fair results in 7%. Complications included subluxation of the ulnar nerve in two cases, one wound dehiscence and one post-operative haematoma.
CONCLUSIONS: The outcome in both groups was the same. Recovery is often prolonged. It took 3-6 months for 69% of patients to recover. Younger patients recovered sooner and the transposition and elderly groups took longer to recover. Simple decompression is adequate unless the nerve is unstable or the bed unsuitable.
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Dr Y Ramguthy
Department of Orthopaedics
Faculty of Health Sciences, University of the Witwatersrand
Tel: (011) 717-2538; Fax: (011) 447-6148
This article was not submitted to an ethical committee for approval. The content of this article is the sole work of the authors. No benefits of any form have been derived from any commercial party related directly or indirectly to the subject of this article.
*This article was awarded 1st prize in the GT du Toit Registrars' Competition.