Purpose
To evaluate the clinical results of revision neurolysis and wrapping with porcine
extracellular matrix (AxoGuard Nerve Protector, AxoGen Inc., Alachua, FL) for cubital
tunnel syndrome after one previous surgical decompression.
Methods
Twelve patients with recurrent cubital tunnel syndrome were treated with decompression,
porcine extracellular matrix nerve wrap, and minimal medial epicondylectomy (if not
previously performed). The average follow-up period was 41 months (range, 24–61 mo).
All patients had recurrent symptoms after having previously undergone one surgical
decompression. The mean patient age was 45 years (range, 30–58 y). All patients were
evaluated subjectively and objectively (pain, satisfaction, static 2-point discrimination,
grip strength, and pinch strength).
Results
A significant improvement was demonstrated in postoperative pain levels (from 8.5
to 1.7), grip strength (from 41% to 86% of the unaffected side), and pinch strength
(from 64% to 83% of the unaffected side). Static 2-point discrimination improved from
an average 10.4 mm preoperatively to 7.6 mm postoperatively. Eleven of 12 patients
demonstrated 2 mm or more improvement in 2-point discrimination postoperatively. There
were no complications related to the use of the porcine extracellular matrix for nerve
wrapping.
Conclusions
This study found that secondary decompression combined with porcine extracellular
matrix nerve wrapping was an effective and safe treatment for patients with recurrent
cubital tunnel syndrome.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Accepted:
February 24,
2015
Received:
October 20,
2014
Footnotes
D.G.S. is a consultant for AxoGen Inc., Alachua, FL.
Identification
Copyright
© 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
