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Chapter 07 Video 1: Cubital Tunnel Syndrome

January 23, 2017

Contributors: Dean G Sotereanos, MD

The skin incision is made 5 centimeters proximal and 5 centimeters distal to the medial epicondyle. The ulnar nerve is identified under the medial intermuscular septum, which is released and excised. Decompression of the ulnar nerve is then carried out around the medial epicondyle. Care is taken to preserve the medial antebrachial cutaneous nerve with more distal dissection. A release of Osborne's band is performed, and distal decompression of the ulnar nerve is performed with care to preserve the flexor carpi ulnaris branch of the ulnar nerve. It is important to preserve the nerve's blood supply. An ulnar nerve subluxation is observed. The medial epicondyle is identified. A subperiosteal epicondylar exposure is carried out. A minimal medial epicondylectomy is performed with an osteotome The excised fragment is shown. Bone wax is applied at the osteotomy site. No ulnar nerve subluxation is observed after the minimal medial epicondylectomy. A subperiosteal flap closure is performed with the suture buried. Again, no ulnar nerve subluxation is observed.

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