J Reconstr Microsurg 2012; 28(05): 345-348
DOI: 10.1055/s-0032-1313766
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The High-Resolution Ultrasonography and Electrophysiological Studies in Nerve Decompression for Ulnar Nerve Entrapment at the Elbow

Wenxiang Zhong
1   Department of Neurosurgery, XinHua Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
,
Wenchuan Zhang
1   Department of Neurosurgery, XinHua Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
,
Xuesheng Zheng
1   Department of Neurosurgery, XinHua Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
,
Shiting Li
1   Department of Neurosurgery, XinHua Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
,
Jun Shi
1   Department of Neurosurgery, XinHua Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
› Author Affiliations
Further Information

Publication History

02 November 2011

13 January 2012

Publication Date:
15 May 2012 (online)

Abstract

Objective To discuss a combination of high-resolution ultrasound and electrophysiological examination in diagnosis and evaluation of ulnar nerve entrapment at the elbow.

Method We retrospectively reviewed 20 healthy volunteers and 278 patients of ulnar nerve entrapment divided into three groups by McGowan grade, and we treated patients with subcutaneous or modified submuscular ulnar nerve transposition randomly. All the patients were followed for 2 years. The diagnosis and effects were confirmed by preoperative or postoperative cross-sectional area (CSA), motor conduction velocity (MCV), sensory conduction velocity, and nerve action potential (NAP).

Results Healthy volunteers and grade I patients had significant differences in CSA, MCV, and NAP; grade I, II, and III patients had significant differences in CSA, MCV, and NAP; all patients had significant differences in CSA, MCV, and NAP before and after operations.

Conclusion High-resolution ultrasound and electrophysiological examination can be used in diagnosis and evaluation of operations of ulnar nerve entrapment at the elbow.

 
  • References

  • 1 Asamoto S, Böker DK, Jödicke A. Surgical treatment for ulnar nerve entrapment at the elbow. Neurol Med Chir (Tokyo) 2005; 45: 240-244 ; discussion 244–245
  • 2 Mitsionis GI, Manoudis GN, Paschos NK, Korompilias AV, Beris AE. Comparative study of surgical treatment of ulnar nerve compression at the elbow. J Shoulder Elbow Surg 2010; 19: 513-519
  • 3 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 Elbow Surg 2006; 15: 609-613
  • 4 Yoon JS, Kim BJ, Kim SJ , et al. Ultrasonographic measurements in cubital tunnel syndrome. Muscle Nerve 2007; 36: 853-855
  • 5 Volpe A, Rossato G, Bottanelli M , et al. Ultrasound evaluation of ulnar neuropathy at the elbow: correlation with electrophysiological studies. Rheumatology (Oxford) 2009; 48: 1098-1101
  • 6 Tang P, Nellans KW. Cubital tunnel syndrome-surgical treatment techniques. Oper Tech Orthopaed 2009; 19: 235-242
  • 7 Machida M, Usui T, Nagaoka T, Satoh K, Asai T, Itagaki T. [Electrophysiological diagnosis in ulnar nerve entrapment at elbow]. Nippon Seikeigeka Gakkai Zasshi 1990; 64: 7-16
  • 8 Jia ZR, Shi X, Sun XR. Pathogenesis and electrodiagnosis of cubital tunnel syndrome. Chin Med J (Engl) 2004; 117: 1313-1316
  • 9 Volpe A, Rossato G, Bottanelli M , et al. Ultrasound evaluation of ulnar neuropathy at the elbow: correlation with electrophysiological studies. Rheumatology (Oxford) 2009; 48: 1098-1101
  • 10 Wiesler ER, Chloros GD, Cartwright MS, Shin HW, Walker FO. Ultrasound in the diagnosis of ulnar neuropathy at the cubital tunnel. J Hand Surg Am 2006; 31: 1088-1093
  • 11 Yoon JS, Walker FO, Cartwright MS. Ultrasonographic swelling ratio in the diagnosis of ulnar neuropathy at the elbow. Muscle Nerve 2008; 38: 1231-1235
  • 12 Practice parameter for electrodiagnostic studies in ulnar neuropathy at the elbow: summary statement. American Association of Electrodiagnostic Medicine, American Academy of Neurology, American Academy of Physical Medicine and Rehabilitation. Muscle Nerve 1999; 22: 408-411
  • 13 Apfelberg DB, Larson SJ. Dynamic anatomy of the ulnar nerve at the elbow. Plast Reconstr Surg 1973; 51: 79-81
  • 14 Craven Jr PR, Green DP. Cubital tunnel syndrome. Treatment by medial epicondylectomy. J Bone Joint Surg Am 1980; 62: 986-989