Clinical outcomes of combined surgical treatment of medial epicondylitis and cubital tunnel syndrome

Surgical results for treatment of medial epicondylitis and cubital tunnel syndrome are generally satisfactory when performed alone. However, our experience suggests a combined procedure is associated with inferior outcomes. A retrospective review was conducted of consecutive surgical cases of medial epicondylectomy/debridement and ulnar nerve decompression during a single operation at our institution from March 2008 to February 2017 using CPT codes. Thirty combined procedures were identified in 29 patients. Fourteen patients and 15 elbows returned to clinic for evaluation at average 4.3 years after surgery (8 men, 6 women, mean age 45.1 years). A Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, visual analogue pain scale (VAS), and physical examination were performed. The data was stratified by type of ulnar nerve procedure and analyzed. Three of fifteen elbows underwent in situ ulnar nerve decompression, and twelve of 15 had transposition, five subcutaneous and seven submuscular. The mean DASH score for in situ decompression was significantly higher than that of transposition (68.2 vs. 13.1). The average visual pain score for patients whom underwent in situ decompression was significantly higher than that of those with ulnar nerve transposition (8.0 vs. 1.2). All other physical exam measures demonstrated no significant difference between the two groups. In situ ulnar nerve decompression in the setting of medial epicondylectomy/debridement may be associated with inferior clinical outcomes in comparison to ulnar nerve transposition. Further studies are needed to validate the results of our study and inform management. Les résultats chirurgicaux du traitement de l’épicondylite médiale et du syndrome du canal cubital sont généralement satisfaisants lorsqu’ils sont réalisés seuls. Cependant, notre expérience suggère qu’une opération combinée est associée à des résultats inférieurs. Une étude rétrospective a été réalisée sur des cas chirurgicaux consécutifs d’épicondylectomie/débridement interne et de décompression du nerf ulnaire au cours d’une opération unique effectuée dans notre établissement entre mars 2008 et février 2017, en utilisant les codes CPT. Trente opérations combinées ont été identifiées chez 29 patients. Quatorze patients et 15 coudes on été revus à la clinique pour évaluation 4,3 ans en moyenne après la chirurgie (8 hommes, 6 femmes, âge moyen 45,1 ans). Un questionnaire Disabilities of the Arm, Shoulder, and Hand (DASH), une