title: Open vs retractor-endoscopic in situ decompression of the ulnar nerve in cubital tunnel syndrome: a retrospective cohort study.
abstract: BACKGROUND
  Both open ulnar nerve decompression and retractor-endoscopic ulnar nerve decompression have been shown to yield good results. However, a comparative evaluation of the techniques is lacking.
  
  
  OBJECTIVE
  To compare the results of open and endoscopic surgery in cubital tunnel syndrome.
  
  
  METHODS
  One hundred fourteen patients undergoing open (n = 59) or endoscopic (n = 55) decompression of the ulnar nerve for cubital tunnel syndrome were retrospectively compared. The long- and short-term outcomes were compared with respect to the time until return to full activity and the duration of postoperative pain. Additionally, matched pairs between the 2 groups were chosen for analysis (n = 34).
  
  
  RESULTS
  Long-term results in the open vs endoscopic groups were as follows: excellent results, 54.2% vs 56.4%; good results, 23.8% vs 32.7%; fair results, 20.3% vs 9.1%; and poor results, 1.7% vs 1.8%, respectively. For the matched pairs, the results had similar significance levels (P = .84). The times until return to full activity in the open vs the endoscopic groups were as follows: 2 to 7 days, 18.6% vs 76.4%; 7 to 14 days, 55.9% vs 10.9%; and > 14 days, 25.4% vs 12.7% (P < .001 between nonmatched and matched pairs). The durations of postoperative pain in the open vs the endoscopic groups were as follows: 1 to 3 days, 45.8% vs 67.3%; 3 to 10 days, 42.5% vs 25.4%; and > 10 days, 11.7% vs 7.3% (P =.04 for nonmatched and P = .05 for matched pairs).
  
  
  CONCLUSIONS
  There are no significant differences in long-term outcomes after open and retractor-endoscopic in situ decompression of the ulnar nerve in cubital tunnel syndrome. The short-term results are significantly better in endoscopic surgery.
authors.affiliation: Department of Neurological Surgery, Johann Wolfgang von Goethe University, Frankfurt/Main, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Dützmann
authors.forename: K Daniel
authors.initials: KD
authors.lastname: Martin
authors.forename: Stephan
authors.initials: S
authors.lastname: Sobottka
authors.forename: Gerhard
authors.initials: G
authors.lastname: Marquardt
authors.forename: Gabriele
authors.initials: G
authors.lastname: Schackert
authors.forename: Volker
authors.initials: V
authors.lastname: Seifert
authors.forename: Kartik G
authors.initials: KG
authors.lastname: Krishnan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D020430:Cubital Tunnel Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D019299:Decompression, Surgical / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D010149:Postoperative Pain / Q000175:diagnosis* / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014459:Ulnar Nerve / Q000473:pathology / Q000601:surgery*; D055815:Young Adult