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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(04): 238-243
DOI: 10.1590/0004-282X20170023
ARTICLE

Modified simple decompression in the treatment of cubital tunnel syndrome: avoiding ulnar nerve subluxation

Descompressão simples modificada no tratamento da síndrome do túnel cubital: evitando subluxação do nervo ulnar
Marcus André Acioly
1   Universidade Estadual do Rio de Janeiro, Disciplina de Neurocirurgia, Rio de Janeiro RJ, Brasil;
2   Universidade Federal do Rio de Janeiro, Disciplina de Neurocirurgia, Rio de Janeiro RJ, Brasil;
,
Amanda Mendes Soares
2   Universidade Federal do Rio de Janeiro, Disciplina de Neurocirurgia, Rio de Janeiro RJ, Brasil;
,
Mariana Lopes de Almeida
2   Universidade Federal do Rio de Janeiro, Disciplina de Neurocirurgia, Rio de Janeiro RJ, Brasil;
,
Renata Barbosa
3   Universidade Estadual do Rio de Janeiro, Disciplina de Dermatologia, Rio de Janeiro RJ, Brasil;
,
Egon Daxbacher
3   Universidade Estadual do Rio de Janeiro, Disciplina de Dermatologia, Rio de Janeiro RJ, Brasil;
,
Carlos Henrique Carvalho
4   Schwarzwald Baar Klinikum, Division of Neurosurgery, Villigen-Schwennigen, Germany.
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ABSTRACT

Objective

In this study, we propose a modification to the simple decompression technique that contains the ulnar nerve in the cubital fossa, thus preventing subluxation during forearm flexion movements.

Methods

Five consecutive patients with leprosy-associated cubital tunnel syndrome underwent surgery with the modified technique between July 2011 and October 2012.

Results

The most common symptoms were neuropathic pain and sensory changes (both 60%). On the McGowan scale, three patients maintained their preoperative score and two patients improved by two points, while on the Louisiana State University Health Sciences Center scale, two patients maintained the same scores, two improved by two points, and one improved by one point. Four patients were able to discontinue corticosteroid use. The mean follow-up time was 25.6 months (range 2-48 months). There were no recurrences or subluxations in the long-term.

Conclusion

This alternative technique resulted in excellent functional results, as well as successful withdrawal from corticosteroids. Furthermore, it resulted in no ulnar nerve subluxations.

RESUMO

Objetivo

Neste manuscrito apresentamos uma modificação da técnica de descompressão simples do nervo ulnar no túnel cubital que impede a subluxação do nervo em movimentos de flexão do antebraço.

Métodos

Foram incluídos cinco pacientes consecutivos acometidos por síndrome do túnel cubital (Hanseníase) submetidos à cirurgia entre 2011 e 2012.

Resultados

Os sintomas mais comuns foram dor neuropática e alterações sensitivas (60%). No pós-operatório, três pacientes mantiveram o mesmo escore e dois melhoraram dois pontos na escala de McGowan, enquanto na escala Louisiana State University Health Sciences Center, dois pacientes mantiveram o mesmo escore, dois melhoraram dois pontos e um melhorou um ponto. Os corticosteróides foram descontinuados em quatro pacientes. O tempo médio de seguimento foi 25,6 meses (variação 2-48 meses). Não foram observadas recorrência ou subluxação no longo prazo.

Conclusões

A técnica alternativa apresentou excelentes resultados funcionais e foi bem sucedida na retirada dos corticosteróides. Ademais, subluxações do nervo ulnar não foram observadas.

cubital tunnel syndrome - decompression - leprosy - peripheral nerves - ulnar nerve
síndrome do túnel ulnar - descompressão - hanseníase - nervos periféricos - nervo ulnar


Publication History

Received: 10 August 2016

Accepted: 30 December 2016

Article published online:
05 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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