Cubital Tunnel In Situ Decompression

The optimum treatment for cubital tunnel syndrome that has failed conservative management is controversial, and many different surgical techniques have been described.The steps in this video demonstrate in situ decompression of the ulnar nerve at the elbow through a small incision.
  1. Exposure. This is the left elbow; the hand is on the viewer's right.
  2. Opening the fibroosseous tunnel.
  3. Proximal dissection, unroofing the sheath and incising the medial intermuscular septum
  4. Distal dissection.
  5. Once the nerve is fully exposed, proximal dissection is up to about 8 cm proximal to the  medial epicondyle, and distal to the origin of the second motor branch within the substance of the flexor carpi ulnaris muscle. Proper retractors are very helpful.
  6. Range of motion demomonstrates no subluxation. The deep surface of the nerve was not disturbed.
  7. Closure.