Heterotopic Ossification of the Elbow after Medial Epicondylectomy / 대한정형외과학회잡지

Postoperative heterotopic ossification of the elbow after surgery for treatment of acute trauma such as fractures and ligament/tendon ruptures has been well-documented. However, literature concerning heterotopic ossification after medial epicondylectomy is scarce. We report on two cases of heterotopic ossification that occurred following medial epicondylectomy for medial epicondylitis and for cubital tunnel syndrome. Preoperatively, calcifications around the medial epicondyle were observed in both patients. These cases suggest that medial epicondylectomy, in the presence of pre-existing calcifications, may pose an increased risk of postoperative heterotopic ossification of the elbow.

Comparative Study between In Situ Decompression of the Ulnar Nerve and Medial Epicondylectomy for Cubital Tunnel Syndrome

PURPOSE: We present our experience of operative results between in situ decompression of the ulnar nerve and medial epicondylectomy for cubital tunnel syndrome. MATERIALS AND METHODS: In 50 cases, we analyzed 32 cases followed more than 12 months. In 32 cases, 17 patients underwent in situ compression and 15 patients underwent medial epicondylectomy. After average follow-up period, we analyzed the operative results. The average follow-up period was 27 months(12~51 months). The results were divided into pain, sense, motor, and function using Gabel & Amadio grade (Table 1), and then estimated by 4 steps. Also, we divided into 3 grades using McGowan grade (Table 2), and then compared the score. RESULTS: The results of in situ decompression were 3 excellent cases, 5 good cases, 7 fair cases, and 2 poor cases by Gabel & Amadio grade. The results of medial epicondylectomy were 3 excellent cases, 4 good cases, 7 fair cases, and 1 poor case by Gabel & Amadio grade. However, there was no significant difference between the in situ decompression(5.45) and medial epicondylectomy(5.78). The results of McGowan grade I were 3 excellent cases, 1 good case. According to Gabel & Amadio grade, the average score was 8.5(range, 7~9) and the results of McGowan grade II were 3 excellent cases, 5 good cases, 5 fair cases, and 1 poor case. According to Gabel & Amadio grade, the average score was 6.7(range, 3~9). Finally, the results of McGowan grade III were 3 good cases, 9 fair cases, 2 bad cases. According to Gabel & Amadio grade, the average score was 4.85(range, 2~7), which was statistically significant difference. CONCLUSION: Statistically there was no significant difference between in situ decompression of the ulnar nerve and medial epicondylectomy for cubital tunnel syndrome. Both operative methods have short operation time, which makes it possible to exercise the joints earlier than other operations. In conclusion, we consider both methods are available for the treatment of cubital tunnel syndrome.

Operative Treatment of Cubital Tunnel Syndrome: A Comparison of Medial Epicondylectomy and Anterior Transposition of the Ulnar Nerves / 대한정형외과학회잡지

PURPOSE: The aim of this study was to compare the results of medial epicondylectomy and anterior submuscular transposition of the ulnar nerve in patients with primary cubital tunnel syndrome. MATERIALS AND METHODS: Thirty patients with primary cubital tunnel syndrome formed the basis of this study. Eighteen patients underwent medial epicondylectomy and twelve patients underwent anterior submuscular transposition of the ulnar nerve. The mean follow-up period was 35 months. Postoperative clinical results were assessed using Gabel and Amadio's rating scale which evaluats pain, sensory and motor function in four grades. Clinical results were compared between two groups in McGowan grades two and three. RESULTS: Two excellent, twelve good and six fair results were obtained in patients with McGowan grade II. In McGowan grade III, three were good, six fair and one was poor. No significant difference in the results was observed between two surgical groups. CONCLUSION: Medial epicondylectomy and anterior submuscular transposition of the ulnar nerve showed no difference in results between patients with primary cubital tunnel syndrome. It seems that medial epicondylectomy is more appropriate because of its simplicity during operation and in terms of postoperative management.