Temporary splint application in extension to prevent ulnar nerve instability after in situ release


AYIK Ö., AYGÜN Ü., ALTAN M., ÖZCAN S.

ANNALS OF CLINICAL AND ANALYTICAL MEDICINE, cilt.13, sa.11, ss.1205-1209, 2022 (ESCI) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 13 Sayı: 11
  • Basım Tarihi: 2022
  • Doi Numarası: 10.4328/acam.21250
  • Dergi Adı: ANNALS OF CLINICAL AND ANALYTICAL MEDICINE
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI)
  • Sayfa Sayıları: ss.1205-1209
  • İstanbul Üniversitesi Adresli: Evet

Özet

Aim: There is still no definitive consensus on cubital tunnel syndrome (CuTS) surgery, for which various surgical methods have been described. Simple in situ release (ISR) is preferred in primary CuTS due to the disadvantages of the anterior transposition (AT) technique, such as being more invasive, more extended surgery duration, particularly devascularization, worsening nerve function, or wound problems. Nevertheless, instability is occasionally observed when the ulnar nerve comes out of its groove during elbow movements after ISR. In this case, a blocking flap or AT is recommended to protect the nerve in situ. The present study aims to present the clinical results of temporary extension splint application applied to maintain the ulnar nerve in its groove in patients with instability noticed after ISR surgery. Material and Methods: Twenty-two patients with a mean age of 46 years diagnosed with primary CuTS were included in the study. All patients were provided with an extension splint for two weeks and a commercial cubital tunnel extension splint for two weeks. The mean follow-up time was 20 months. Results: Clinical outcomes such as Visual Analog Score (VAS), Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, pinch strength, grip strength, 2-point discrimination, recovery of motor functions, and functional and aesthetic satisfaction were positive. Only one patient (4.5 %) required secondary surgery. Discussion: The simple, temporary extension splinting method is an effective way to address instability that may develop after ISR that is neither timeconsuming nor more invasive.