Comparison of Subcutaneous Anterior Transposition and In Situ Decompression Techniques of Ulnar Nerve Surgery in Cubital Tunnel Syndrome

Purpose: This study aims to compare two prevalent surgical techniques for cubital tunnel syndrome (CuTS): ulnar nerve in situ decompression (ISD) and subcutaneous anterior transposition (SAT), with an emphasis on clinical outcomes, surgical period, and complications.Material Methods: Sixty-nine patients who underwent surgery for CuTS between 2018 and 2023 and were followed up for a minimum of 12 months were retrospectively evaluated. Patients whose diagnosis was confirmed by electromyography and who had symptoms that persisted despite conservative treatment were included in the study. Patients were divided into two groups based on the surgical technique used: ISD (Group 1, n = 37) and SAT (Group 2, n = 32). The groups were compared in terms of demographic characteristics, preoperative Dellon classification, surgical duration, complications, and clinical outcomes at the last follow-up. Clinical evaluation was performed using the Visual Analog Scale (VAS), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), Modified Bishop score, and range of motion (ROM) of the elbow.Results: The mean age of the patients was 42.36±12.16 years, and the mean follow-up period was 48.36±24.47 months. No significant differences were found between the groups in terms of age, gender, affected side, dominant extremity distribution, and preoperative Dellon stages (p>0.05). The mean surgical time was significantly shorter in the ISD group compared to the SAT group (34.76±8.65 min vs. 55.41±13.25 min; p0.05 for all). Complication rates were 8.1% in the ISD group and 6.3% in the SAT group, with no significant difference between the groups.Conclusion: In cubital tunnel syndrome surgery, ISD and SAT techniques provide similar results in terms of clinical efficacy. However, ISD stands out as a practical and effective surgical option in the appropriate patient group due to its shorter surgical time and limited surgical dissection requirements. The choice of surgical technique should be individualized according to the patient's specific clinical and anatomical characteristics.