260 Ultrasonography-Guided Minimally Invasive Decompression for Cubital Tunnel Syndrome: Adapting Techniques from Carpal Tunnel Syndrome Management

INTRODUCTION: Current management via open dissection for cubital tunnel syndrome is efficacious; however, it often leads to lengthy patient recovery. Sonography can be utilized in open dissections to minimize incision lengths, but it has garnered interest in cadaveric studies for achieving entirely minimally invasive cubital tunnel decompressions. METHODS: Dissections were performed on three cadaveric arms. Pre-surgical mapping of the ulnar nerve was performed via ultrasonography, identifying the ulnar nerve traversing muscular and bony landmarks through the elbow. Operating bidirectionally via a single site at the level of the cubital tunnel, the carpal tunnel release system was utilized under live ultrasonographics, rigidly simulating surgical operation in regards to time, technique, and care of dissection. Post-operative confirmation of decompression was achieved via open dissection. RESULTS: In all three specimens, successful fascial release was confirmed. There was no injury to the ulnar nerve itself or any motor branches, and there was no identifiable subluxation of the nerve with complete ranging of the elbow. The operation itself was characterized by a quick learning curve as the final release was completed in seven minutes as compared to the 14 minute procedure time of the first operation. CONCLUSIONS: This study demonstrates the feasibility of in-office cubital tunnel decompression, addressing the growing demand for minimally invasive interventions. By adapting techniques from carpal tunnel syndrome management, this approach offers a safe and efficient alternative to traditional open surgery, particularly relevant amidst limitations on operating theater access. Such innovative strategies hold promise for expanding surgical options and meeting the evolving needs of patients, emphasizing the importance of adapting established techniques to address emerging challenges in patient care.