Validation of preoperative nerve conduction studies by intraoperative studies in patients with ulnar neuropathy at the elbow.
OBJECTIVE
To validate the findings of preoperative motor short-segment nerve conduction studies (SSNCSs) by intraoperative SSNCSs in patients with cubital tunnel syndrome.


METHODS
We prospectively recruited patients with ulnar neuropathy at the elbow (UNE) localized distal to the medial epicondyle (ME). Preoperatively, motor SSNCSs and ultrasonography (US) were performed. Immediately after surgical dissection of the humeroulnar aponeurotic arcade (HUA), intraoperative near-nerve motor SSNCSs were performed, and compared to preoperative findings.


RESULTS
We studied 36 arms with UNE in the cubital tunnel. Preoperative US localized UNE distal to ME in all operated arms, and demonstrated ulnar nerve constriction in 19 of them. Visual inspection confirmed ulnar nerve swelling in all studied nerves, but was unreliable with regard to ulnar nerve constriction. In all 5 (14%) arms with inconclusive localization by SSNCSs, intraoperative SSNCSs confirmed the preoperative US diagnosis of cubital tunnel syndrome. Intraoperative SSNCSs confirmed the preoperative localization in 24 (67%) arms, and were non-contributive in 7 (19%) arms with intraoperatively non-recordable responses.


CONCLUSIONS
Intraoperative near-nerve SSNCSs did not change the localization in any of 36 arms with UNE distal to ME. Therefore, our data indicate that a combination of preoperative SSNCSs and US reliably localizes UNE in the cubital tunnel.


CONCLUSIONS
Our present study suggests that in arms with consistent preoperative SSNCSs and US studies, no intraoperative near-nerve SSNCSs are needed to confirm ulnar nerve entrapment under the HUA.
Institute of Clinical Neurophysiology, Division of Neurology, University Medical Center Ljubljana, Slovenia. Electronic address: gregor.omejec@kclj.si.
Gregor
G
Omejec
Department of Plastic, Aesthetic and Reconstructive Surgery, Division of Surgery, University Medical Center Ljubljana, Slovenia. Electronic address: kresimir.bozikov@kclj.si.
Krešimir
K
Božikov
Institute of Clinical Neurophysiology, Division of Neurology, University Medical Center Ljubljana, Slovenia. Electronic address: simon.podnar@kclj.si.
Simon
S
Podnar
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D064795:Intraoperative Neurophysiological Monitoring / Q000379:methods / Q000592:standards*; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology*; D011300:Preoperative Care / Q000379:methods / Q000592:standards*; D011446:Prospective Studies; D020424:Ulnar Neuropathies / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery
Cubital tunnel; Intraoperative near-nerve studies; Short-segment nerve conduction studies; Ulnar neuropathy at the elbow