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Endoscopic detection of compressing fascial bands around the ulnar nerve within the FCU

  • Surgery Articles
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HAND

Abstract

Background

The aim of this study is to endoscopically evaluate the ulnar nerve proximal and distal to the cubital tunnel after in situ decompression to identify and eventually release fascial bands capable of compressing the ulnar nerve.

Methods

We performed a retrospective review of 16 ulnar nerve compression cases in 12 patients. Eight men and four women with a mean age of 52 years (range, 23–77 years) were clinically diagnosed and confirmed with neurophysiologic studies. A 4–6-cm curvilinear incision was made at the medial elbow, and the ulnar nerve was identified and decompressed at the cubital tunnel. Then, a 2.7-mm endoscope was passed 8 to 10 cm proximal and distal to the medial epicondyle allowing for visualization of the ulnar nerve and its surrounding soft tissues.

Results

The endoscopic evaluation of the 16 ulnar nerves demonstrated no compressive bands outside of the cubital tunnel. All patients had satisfactory outcomes.

Conclusions

The good results reported after in situ ulnar nerve decompression have questioned the need for endoscopically assisted decompression of the ulnar nerve proximal and distal to the cubital tunnel. Some authors suggest the existence of fascial bands within the flexor carpi ulnaris (FCU) capable of compressing the ulnar nerve. This study would suggest that fibrous bands deep in the FCU capable of compressing the ulnar nerve do not exist. Our satisfactory outcomes would support the perception that extensive decompression of the ulnar nerve beyond the cubital tunnel is not routinely needed.

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Conflict of Interest

There are no disclosures of financial support or possible conflict of interest on behalf of any of the three authors listed above. DJN serves as the President of the American Society for Surgery of the Hand (ASSH) and has ownership in Upex.

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Authors and Affiliations

  1. Chicago Center for Surgery of the Hand, Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, 737 N Michigan Ave #700, Chicago, IL, 60611, USA

    Daniel J. Nagle

  2. Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, 401 E. Ontario Street, #1707, Chicago, IL, 60611, USA

    Ronak M. Patel

  3. Department of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Sonya Paisley

Authors
  1. Daniel J. Nagle
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  2. Ronak M. Patel
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  3. Sonya Paisley
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Corresponding author

Correspondence to Ronak M. Patel.

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Nagle, D.J., Patel, R.M. & Paisley, S. Endoscopic detection of compressing fascial bands around the ulnar nerve within the FCU. HAND 7, 103–107 (2012). https://doi.org/10.1007/s11552-011-9377-x

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  • DOI: https://doi.org/10.1007/s11552-011-9377-x

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