Purpose
The purpose of this study was to compare the intraneural microvascular patterns of
the ulnar nerve at 2 elbow flexion angles in asymptomatic volunteers and patients
with cubital tunnel syndrome (CuTS) and to evaluate the effects of surgery on the
microvascular pattern in patients with CuTS by using contrast-enhanced ultrasonography
(CEUS).
Methods
This study included 10 elbows in 10 asymptomatic volunteers (control group) and 10
elbows in 10 patients with CuTS who underwent anterior subcutaneous transposition
of the ulnar nerve (CuTS group). The CuTS group underwent clinical and electrophysiologic
examinations and CEUS before surgery and at 1, 2, and 3 months after surgery. The
intraneural enhancement pattern was calculated as an area under the curve (AUC) value
in the entrapment site of the ulnar nerve within the cubital tunnel and in the area
1 cm proximal to the site (proximal site) at elbow flexion angles of 20° and 110°.
Results
Serial electrophysiologic examinations showed improvements at 1, 2, and 3 months after
surgery compared with before surgery. In the control group, the AUC values of the
central part of the cubital tunnel and proximal sites showed no substantial changes
with the increase in elbow flexion. In the CuTS group, the AUC in the proximal site
at 110° of elbow flexion was decreased compared with that at 20° of flexion before
surgery. The AUC values for both the entrapment and proximal sites at 20° and 110°
of elbow flexion were the most increased at 2 months after surgery compared with before
surgery.
Conclusions
Increased elbow flexion in patients with CuTS influences the intraneural blood flow
of the ulnar nerve. Surgery for CuTS alters the intraneural blood flow.
Clinical relevance
Quantitative evaluation of the intraneural blood flow of the ulnar nerve using CEUS
may be a new supplementary diagnostic tool for CuTS and an indicator for the evaluation
of postoperative recovery from nerve damage.
Key words
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Article info
Publication history
Published online: August 27, 2021
Accepted:
June 30,
2021
Received:
May 8,
2020
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
