Minimal Medial Epicondylectomy

  • Loukia K. Papatheodorou
  • Dean G. Sotereanos


The minimal medial epicondylectomy is an effective alternative technique for the surgical treatment of primary or recurrent cubital tunnel syndrome. This technique can address the compressive and tensile forces on the ulnar nerve while preserving the ulnar nerve’s intraneural and extraneural blood supply as compared to other ulnar nerve transposition techniques. To avoid the potential complication of medial elbow instability, it is important to preserve the anterior band of the medial collateral ligament excising less than 20% of medial epicondyle in the coronal plane.


Cubital tunnel syndrome Medial epicondylectomy Minimal medial epicondylectomy Recurrent cubital tunnel syndrome Ulnar nerve compression Ulnar neuropathy at the elbow 


  1. 1.
    Ogata K, Manske PR, Lesker PA. The effect of surgical dissection on regional blood flow to the ulnar nerve in the cubital tunnel. Clin Orthop Relat Res. 1985;193:195–8.Google Scholar
  2. 2.
    Heithoff SJ, Millender LH, Nalebuff EA, Petruska AJ Jr. Medial epicondylectomy for the treatment of ulnar nerve compression at the elbow. J Hand Surg Am. 1990;15(1):22–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Bednar MS, Blair SJ, Light TR. Complications of the treatment of cubital tunnel syndrome. Hand Clin. 1994;10(1):83–92.PubMedGoogle Scholar
  4. 4.
    King T, Morgan FP. Late results of removing the medial humeral epicondyle for traumatic ulnar neuritis. J Bone Joint Surg Br. 1959;41(1):51–5.CrossRefPubMedGoogle Scholar
  5. 5.
    Popa M, Dubert T. Treatment of cubital tunnel syndrome by frontal partial medial epicondylectomy: a retrospective series of 55 cases. J Hand Surg (Br). 2004;29(6):563–7.CrossRefGoogle Scholar
  6. 6.
    Kaempffe FA, Farbach J. A modified surgical procedure for cubital tunnel syndrome: partial medial epicondylectomy. J Hand Surg Am. 1998;23(3):492–9.CrossRefPubMedGoogle Scholar
  7. 7.
    Muermans S, De Smet L. Partial medial epicondylectomy for cubital tunnel syndrome: outcome and complications. J Shoulder Elb Surg. 2002;11(3):248–52.CrossRefGoogle Scholar
  8. 8.
    Amako M, Nemoto K, Kawaguchi M, Kato N, Arino H, Fujikawa K. Comparison between partial and minimal medial epicondylectomy combined with decompression for the treatment of cubital tunnel syndrome. J Hand Surg Am. 2000;25(6):1043–50.CrossRefPubMedGoogle Scholar
  9. 9.
    O’Driscoll SW, Jaloszynski R, Morrey BF, An KN. Origin of the medial ulnar collateral ligament. J Hand Surg Am. 1992;17(1):164–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Gobel F, Musgrave DS, Vardakas DG, Vogt MT, Sotereanos DG. Minimal medial epicondylectomy and decompression for cubital tunnel syndrome. Clin Orthop Relat Res. 2001;393:228–36.CrossRefGoogle Scholar
  11. 11.
    Kim KW, Lee HJ, Rhee SH, Baek GH. Minimal epicondylectomy improves neurologic deficits in moderate to severe cubital tunnel syndrome. Clin Orthop Relat Res. 2012;470(5):1405–13.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Osei DA, Padegimas EM, Calfee RP, Gelberman RH. Outcomes following modified oblique medial epicondylectomy for treatment of cubital tunnel syndrome. J Hand Surg Am. 2013;38(2):336–43.CrossRefPubMedGoogle Scholar
  13. 13.
    Erol B, Tetik C, Sirin E. The mid-term results of minimal medial epicondylectomy and decompression for cubital tunnel syndrome. Acta Orthop Traumatol Turc. 2004;38(5):330–6.PubMedGoogle Scholar
  14. 14.
    Jarrett CD, Papatheodorou LK, Sotereanos DG. Cubital tunnel syndrome. Instr Course Lect. 2017;15(66):91–101.Google Scholar
  15. 15.
    Rogers MR, Bergfield TG, Aulicino PL. The failed ulnar nerve transposition. Etiology and treatment. Clin Orthop Relat Res. 1991;269:193–200.Google Scholar
  16. 16.
    Dellon AL. Techniques for successful management of ulnar nerve entrapment at the elbow. Neurosurg Clin N Am. 1991;2(1):57–73.CrossRefPubMedGoogle Scholar
  17. 17.
    Wilson DH, Krout R. Surgery of ulnar neuropathy at the elbow: 16 cases treated by decompression without transposition. J Neurosurg. 1973;38(6):780–5.CrossRefPubMedGoogle Scholar
  18. 18.
    Baek GH, Kwon BC, Chung MS. Comparative study between minimal medial epicondylectomy and anterior subcutaneous transposition of the ulnar nerve for cubital tunnel syndrome. J Shoulder Elb Surg. 2006;15(5):609–13.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Loukia K. Papatheodorou
    • 1
  • Dean G. Sotereanos
    • 1
  1. 1.Orthopaedic Specialists – UPMCUniversity of Pittsburgh School of MedicinePittsburghUSA

Personalised recommendations