Outcomes of Posterior Oblique Medial Epicondylectomy for the Treatment of Cubital Tunnel Syndrome

Abstract

Purpose

To evaluate the clinical outcomes and complication rates after posterior oblique medial epicondylectomy for the treatment of cubital tunnel syndrome (CuTS) and assess its efficacy in improving motor and sensory function with minimal postoperative morbidity.

Methods

We retrospectively reviewed 48 patients (51 extremities) with CuTS who underwent posterior oblique medial epicondylectomy between 2015 and 2023. All surgeries were performed by a single senior surgeon. Patients were assessed before surgery and at a mean follow-up of 22 months by using the McGowan grading system, the Wilson and Krout classification, grip and pinch strength, two-point discrimination, Quick Disabilities of the Arm, Shoulder, and Hand, and visual analog scale scores. Statistical analysis included the Fisher exact test and the Wilcoxon signed-rank sum test.

Results

After surgery, 90% of extremities improved by at least one McGowan grade. Wilson and Krout grading revealed outcomes of “excellent” in 31 patients, “good” in 17 patients, and “fair” in 3 patients. Significant improvements occurred in two-point discrimination (ring/little finger: from 12 to 6 mm) (P < .001), side pinch (from 4.0 to 6.5 kg) (P < .001), tip pinch (from 3.0 to 4.5 kg) (P < .001), and grip strength (from 25 to 30 kg) (P < .001). Quick Disabilities of the Arm, Shoulder, and Hand scores improved from 27 to 9.1, and visual analog scale scores decreased from 30 to 10 (P < .001). No patient had symptomatic ulnar nerve subluxation or elbow instability. Six patients reported mild medial elbow pain.

Conclusions

Posterior oblique medial epicondylectomy for CuTS yielded favorable outcomes with significant improvement in motor and sensory function and minimal complications. This technique may offer advantages over traditional medial epicondylectomy by preserving elbow stability and enabling early active range of motion during the postoperative period.

Clinical relevance

Therapeutic IV.