Vein wrapping at cubital tunnel for ulnar nerve problems

Background

Recurrent compression of the ulnar nerve in the cubital tunnel is a difficult problem and many solutions have been tried with variable success. Autologous vein graft wrapping is an alternative technique and it is recommended for the treatment of recalcitrant ulnar nerve compression in which 2 or more previous surgical procedures have failed to resolve the problem.

Methods

Seventeen patients with recurrent cubital tunnel syndrome were treated with autologous saphenous vein wrapping. These patients had previously undergone simple decompression, decompression combined with medial epicondylectomy, anterior submuscular, or intramuscular transposition with internal neurolysis and had persistence of symptoms. Each patient underwent both subjective and objective evaluation.

Results

Our clinical results on 17 patients have been encouraging. All patients reported significant pain relief, while improvements in grip strength and 2-point discrimination were also observed. There were no complications, other than transient leg swelling secondary to harvesting the saphenous vein graft from the leg.

Conclusion

This technique is not technically demanding, has low donor site morbidity, and leads to pain relief and high patient satisfaction.

Level of Evidence: Review Article

Keywords: Cubital tunnel, recurrent compression neuropathy, vein wrapping, ulnar nerve