The management of failed cubital tunnel decompression

Cubital tunnel decompression is a commonly performed operation with a much higher failure rate than carpal tunnel release. Failed cubital tunnel release generally occurs due to an inadequate decompression in the primary procedure, new symptoms due to an iatrogenic cause, or development of new areas of nerve irritation. Our preferred technique for failed release is revision circumferential neurolysis with medial epicondylectomy, as this eliminates strain, removes the risk of subluxation, and avoids the creation of secondary compression points. Adjuvant techniques including supercharging end-to-side nerve transfer and nerve wrapping show promise in improving the results of revision surgery. Limited quality research exists in this subject, compounded by the lack of consensus on diagnostic criteria, classification, and outcome assessment.

Automated summary

Cubital tunnel decompression is a commonly performed operation with a higher failure rate than carpal tunnel release. Failed procedures are often due to inadequate decompression, iatrogenic causes, or new areas of nerve irritation. Revision circumferential neurolysis with medial epicondylectomy is a preferred technique for failed surgeries, while other adjuvant techniques like supercharging end-to-side nerve transfer and nerve wrapping show promise in improving results. However, limited quality research and lack of consensus on diagnostic criteria, classification, and outcome assessment exist in this field.