Original Communications| Volume 25, ISSUE 6, P1043-1050, November 2000

Comparison between partial and minimal medial epicondylectomy combined with decompression for the treatment of cubital tunnel syndrome


      We have performed minimal medial epicondylectomy for cubital tunnel syndrome since 1990 to preserve the anterior medial collateral ligament. In this study we compared surgical outcomes between partial medial epicondylectomy (14 patients) and minimal medial epicondylectomy (18 patients) combined with ulnar nerve decompression for the treatment of cubital tunnel syndrome. Mean preoperative Yasutake scores were 57 ± 17 points (±SD) in the partial epicondylectomy group and 60 ± 15 points in the minimal medial epicondylectomy group. The postoperative scores were 79 ± 19 points and 87 ± 10 points, respectively. Both groups had significant improvement in their Yasutake scores following medial epicondylectomy. Similar improvements in motor conduction velocity were observed. There was no significant difference in improvement of either the Yasutake scores or the motor conduction velocity between the 2 groups. Valgus instability of the elbow was significantly greater in the partial epicondylectomy group. We therefore conclude that minimal medial epicondylectomy combined with ulnar nerve decompression is an effective treatment for cubital tunnel syndrome and that a larger excision of the medial epicondyle should be avoided. (J Hand Surg 2000;25A:1043-1050. Copyright © 2000 by the American Society for Surgery of the Hand.)


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Hand Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • McPherson SA
        • Meals RA
        Cubital tunnel syndrome.
        Orthop Clin North Am. 1992; 23: 111-123
        • Amako M
        • Nemoto K
        • Nakajima H
        • Imai T
        Clinical results of cubital tunnel syndrome.
        J East Jpn Assoc Orthop Traumatol. 1994; 6: 179-182
        • Froimson AI
        • Anouchi YS
        • Seitz Jr, WH
        • Winsberg DD
        Ulnar nerve decompression with medial epicondylectomy for neuropathy at the elbow.
        Clin Orthop. 1991; 265: 200-206
        • Eversmann Jr, WW
        Entrapment and compression neuropathies.
        in: 3rd ed. Operative hand surgery. Churchill Livingstone, New York1993: 1341-1385
        • O'Driscoll SW
        • Jaloszynski R
        • Morrey BF
        • An K-N
        Origin of the medial ulnar collateral ligament.
        J Hand Surg. 1992; 17A: 164-168
        • Amako M
        • Nemoto K
        • Kawaguchi M
        • Usui H
        • Arino H
        • Fujikawa K
        Modified epicondylectomy for cubital tunnel syndrome.
        J Jpn Elbow Soc. 1997; 4: 99-100
        • Inoue S
        • Harada M
        • Toh S
        • Tsubo K
        • Narita S
        Valgus instability of the elbow after resection of the medial epicondyle.
        J Jpn Elbow Soc. 1994; 1: 101-102
        • Yasutake S
        • Koshino T
        • Takazawa H
        • Yamaguchi S
        • Hozumi Y
        Clinical evaluations of medial epicondylectomy with neurolysis for cubital tunnel syndrome.
        Seikeigeka. 1983; 34: 1667-1669
        • Inoue S
        • Toh S
        • Harada M
        • Zeniya M
        • Narita S
        Valgus instability of the elbow after resection of the medial epicondyle (King's method).
        J Jpn Soc Surg Hand. 1993; 10: 419-423
        • King T
        • Morgan FP
        Late results of removing the medial humeral epicondyle for traumatic ulnar neuritis.
        J Bone Joint Surg. 1959; 41B: 51-55
        • King T
        The treatment of traumatic ulnar neuritis: mobilization of the ulnar nerve at the elbow by removal of the medial epicondyle and adjacent bone.
        Aust N Z J Surg. 1950; 20: 33-42
        • Ogata K
        • Manske PR
        • Lester PA
        The effect of surgical dissection on regional blood flow to the ulnar nerve in the cubital tunnel.
        Clin Orthop. 1985; 193: 195-198
        • Goldberg BJ
        • Light TR
        • Blair SJ
        Ulnar neuropathy at the elbow: results of medial epicondylectomy.
        J Hand Surg. 1989; 14A: 182-188
        • Froimson AI
        • Zahrawi F
        Treatment of compression neuropathy of the ulnar nerve at the elbow by epicondylectomy and neurolysis.
        J Hand Surg. 1980; 5: 391-395
        • Heithoff SJ
        • Millender LH
        • Nalebuff EA
        • Petruska Jr, AJ
        Medial epicondylectomy for the treatment of ulnar nerve compression at the elbow.
        J Hand Surg. 1990; 15A: 22-29
        • Kaempffe FA
        • Farbach J
        A modified surgical procedure for cubital tunnel syndrome: partial medial epicondylectomy.
        J Hand Surg. 1998; 23A: 492-499
        • Imamura K
        The medial epicondyle of the humerus, an anatomical study.
        J Jpn Orthop Assoc. 1995; 69: 951-963
        • Gore D
        • Larson S
        Medial epicondylectomy for subluxing ulnar nerve.
        Am J Surg. 1966; 111: 851-853
        • Dellon AL
        • Chang E
        • Coert JH
        • Campbell KR
        Intraneural ulnar nerve pressure changes related to operative techniques for cubital tunnel decompression.
        J Hand Surg. 1994; 19A: 923-930