Endoscopic vs Open Decompression of the Ulnar Nerve in XXXX : A Prospective Randomized Double-Blind Study.

@entity1 @entity7769 @entity1410 @entity1795
BACKGROUND: Prospective randomized data for comparison of endoscopic and open decompression methods are lacking. OBJECTIVE: To compare the long- and short-term results of endoscopic and open decompression in @entity7769 . METHODS: In a prospective randomized double-blind study, 54 @entity1 underwent ulnar nerve decompression for 56 @entity7769 from October 2008 to April 2011. All @entity1 presented with typical clinical and neurophysiological findings and underwent preoperative nerve ultrasonography. They were randomized for either endoscopic (n = 29) or open (n = 27) surgery. Both @entity1 and the physician performing the follow-up examinations were blinded. The follow-up took place 3, 6, 12, and 24 months postoperatively. The severity of symptoms was measured by McGowan and Dellon Score, and the clinical outcome by modified Bishop Score. Additionally, the neurophysiological data were evaluated. RESULTS: No differences were found regarding clinical or neurophysiological outcome in both early and late follow-up between both groups. @entity1410 were more frequent after endoscopic decompression (P = .05). The most frequent constrictions were found at the @entity1795 ( @entity1795 ) arch and the retrocondylar retinaculum. We found no compressing structures more than 4 cm distal from the sulcus in the endoscopic group. The outcome was classified as "good" or "excellent" in 46 out of 56 @entity1 (82.1%). Eight @entity1 did not improve sufficiently or had a relapse and underwent a second surgery. CONCLUSION: The endoscopic technique showed no additional benefits to open surgery. We could not detect relevant compressions distal to the @entity1795 arch. Therefore, an extensive far distal endoscopic decompression is not routinely required. The open decompression remains the procedure of choice at our institution. ABBREVIATION: Dig, digitFCU, flexor carpi ulnarisNAS, numeric analog scale.
