title: A simple, safe and reliable surgical landmark for medial epicondylectomy.
abstract: BACKGROUND
  Various surgical strategies have been described for the treatment of cubital tunnel syndrome, including medial epicondylectomy. This aims to decompress the ulnar nerve and allow a 'mini anterior transposition'. The major concern over medial epicondylectomy is the potential for postoperative iatrogenic valgus instability.
  
  
  METHODS
  We utilized a surgical landmark for medial epicondylectomy based on the medial aspect of the ulnar nerve with the elbow in 90° of flexion in 12 cadaveric upper limbs. The size of the resultant fragment was measured and, subsequently, the medial collateral ligament was dissected and the elbow stressed to assess its integrity.
  
  
  RESULTS
  This technique resulted in the excision of a fragment of mean width 8 mm (range 6 mm to 11 mm) and allowed the ulnar nerve to smoothly translate anteriorly in flexion. The anterior band of the ulnar collateral ligament was macroscopically preserved in all cases and there was no valgus instability.
  
  
  CONCLUSIONS
  The medial border of the ulnar nerve is a simple, safe and reliable surgical landmark for medial epicondylectomy. This technique offers advantages over other described methods of assessing the location at which to perform a medial epicondylectomy.
authors: Sydney Orthopaedic and Arthritis Specialists, Sydney Orthopaedic Arthritis and Sports Medicine, Chatswood, NSW, Australia.
authors: Geoffrey Cs
authors: GC
authors: Smith
authors: Hand Unit, Bristol Royal Infirmary, Bristol, UK.
authors: Philip S
authors: PS
authors: McCann
authors: Hand Unit, Bristol Royal Infirmary, Bristol, UK.
authors: Damian
authors: D
authors: Clark
authors: Hand Unit, Bristol Royal Infirmary, Bristol, UK.
authors: Rouin
authors: R
authors: Amirfeyz
keywords: Cubital tunnel syndrome; medial epicondylectomy; surgery; technique