Cubital tunnel syndrome: Simple decompression versus decompression and anterior subcutaneous transposition

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 postoperative 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.