Cubital Tunnel Revision After Transposition: A Single Center Experience

Abstract

Purpose

The purpose of this study was to assess the rates of revision after cubital tunnel release with transposition among three different transposition techniques in a single institution.

Methods

A retrospective chart review of all cubital tunnel surgeries over a 5-year period was performed via a query of the billing records of three different surgeons who typically perform three different types of transposition. This yielded 937 records. After eliminating records with incomplete clinical information (141 records), a total of 796 records were evaluated, with 540 representing in situ releases and 255 transpositions. The transposition cohort was further evaluated, and 39 records were eliminated as the operation was performed for traumatic or post-traumatic indications, leaving 216 transpositions performed between December 1, 2016, and December 1, 2021.

Results

In the 216 cubital tunnel releases with transposition performed, 82 (38%) were subcutaneous transpositions, 71 (33%) were subfascial transpositions, and 63 (29%) were submuscular transpositions. Twenty of the 216 cubital tunnel releases with transpositions that were performed in this study period represented revision surgeries. Eleven were revisions after an in situ release, and eight were revisions after a transposition. One is unknown as the index operation was performed by an outside physician whose operative note was not available. Of the revision surgeries performed, 10 represented revisions of index cases performed by our institution with six being revisions for an in situ release and four revisions after a transposition. Of those four revisions after a transposition, one was performed for a subcutaneous transposition, two were following subfascial transpositions, and one was following a submuscular transposition. The average time from index operation to revision after a transposition was 16.3 months.

Conclusions

The rate of revision surgery following cubital tunnel release with transposition is quite low, and there do not appear to be major differences in the rate of revision among the different types of surgical transposition, indicating that a true subcutaneous transposition may be adequate.

Type of study/level of evidence

Therapeutic III.