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Najdmazhar F, Shariatzadeh H, Hamadiyan H, Ibrahim Hasasn A, Layeghi A. Comparison of Anterior Transposition of the Ulnar Nerve by Subcutaneous and Transmuscular Methods in the Treatment of Cubital Tunnel Syndrome. JROS 2023; 10 (2) :81-88
URL: http://jros.iums.ac.ir/article-1-2225-en.html

Background: Cubital tunnel syndrome is the second most common upper extremity compression neuropathy. Anterior transposition of the ulnar nerve is the standard method to treat cubital tunnel syndrome. 
Objectives: This study aims to compare the therapeutic results of subcutaneous and transmuscular surgical methods for anterior transposition of the ulnar nerve.
Methods: In this retrospective cohort study, patients with cubital tunnel syndrome who underwent anterior transposition of the ulnar nerve (subcutaneous or transmuscular) between 2016 and 2022 were included. According to the Wilson & Krout score, the evaluation of the treatment result in the last follow-up was classified into four groups: excellent, good, acceptable, and poor.
Results: A total of 102 upper limbs were evaluated; 58 patients were men, and 40 were women. The average age of the patients was 50.43±18.10 years. Fifty-four upper limbs underwent transmuscular surgery, while the others underwent subcutaneous surgery. No statistically significant relationship was found between treatment results with the surgical method (P=0.617). A statistically significant relationship was found between the treatment results and the patient’s chief complaint, clawing, Wartenberg, and electromyography-nerve conduction velocity (EMG-NCV) severity. A statistically significant (P=0.004) relationship was found between the duration of symptoms before surgery and treatment results.
Conclusion: The two surgical methods for treating cubital tunnel syndrome produced similar results, and the prolongation of symptoms before surgery and the presence of clinical findings, such as clawing and Wartenberg signs, suggest a poor prognosis.