Medial epicondylectomy for cubital tunnel syndrome: Outcomes from an 8-year retrospective cohort study

Background: Cubital tunnel syndrome (CuTS) reflects ulnar nerve dysfunction due to compression at the elbow. There is no consensus regarding optimal management, with conflicting evidence in the literature. This study aimed to report the treatment of CuTS with medial epicondylectomy (ME), including clinical outcomes and complication rates. Methods: A retrospective cohort study of cubital tunnel decompression with medial epicondylectomy was conducted over an 8-year timeframe at a single centre for peripheral nerve surgery. A minimum of 24 weeks of follow-up was required for outcome analysis. Disease severity was assessed using McGowan grading and baseline neurophysiology studies. Clinical outcomes were rated using the Wilson-Krout reporting system for disease response to intervention. We compared the primary outcome variable (McGowan grade) using anova omnibus test and linear regression models to assess the effect of different intraoperative findings on the clinical outcome. Results: In total 185 patients were included. 82% had a Wilson-Krout grade of Good or Excellent. Patients showed significant improvement during the first six weeks after surgery (MD 1.065, 95% CI 0.90 - 1.23). However, no statistically significant improvement was noted in the period between 6 and 24 weeks (24 MD 0.168, 95% CI −0.01 - 0.35). A severe neurophysiological score at intake was associated with worse outcomes (Df 5, X2 = 2.37, F = 3.69, p = 0.004). The overall rate of complications from performing ME was 7.6%, but no elbow instability was evident. Conclusions: ME is a safe treatment option for cubital tunnel syndrome with an acceptable complication rate.