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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(01): 114-120
DOI: 10.1055/s-0042-1742623
Artigo Original
Ombro e Cotovelo

Endoscopic Cubital Tunnel Release in Leprosy Neuritis of the Ulnar Nerve

Article in several languages: português | English
José Alberto Dias Leite 
1   Departamento de Cirurgia, Universidade Federal do Ceará, Fortaleza, CE, Brasil
,
Antônio Carlos Delgado Sampaio 
1   Departamento de Cirurgia, Universidade Federal do Ceará, Fortaleza, CE, Brasil
,
Claudio Manoel Gonçalves da Silva Leite 
1   Departamento de Cirurgia, Universidade Federal do Ceará, Fortaleza, CE, Brasil
,
Janaina Gonçalves da Silva Leite 
1   Departamento de Cirurgia, Universidade Federal do Ceará, Fortaleza, CE, Brasil
,
Marina Vasconcelos Sampaio 
1   Departamento de Cirurgia, Universidade Federal do Ceará, Fortaleza, CE, Brasil
,
Diego Ariel de Lima 
2   Federal Rural do Semi-Árido (UFERSA), Mossoró, RN, Brasil
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Abstract

Objectives To better characterize the role of endoscopic cubital tunnel release in leprosy neuritis and determine whether there is an improvement in pain, sensitivity, and strength with the use of this minimally invasive technique.

Methods A total of 44 endoscopic procedures for ulnar nerve decompression at the elbow were performed in patients who were previously diagnosed with leprosy neuritis. The inclusion criteria were surgical indication for ulnar nerve release and clinical treatment failure for 4 weeks in patients with cubital tunnel syndrome who had their ulnar nerve function, whether motor or sensitive, deteriorated progressively despite the treatment with prednisone 1 mg/kg/day and physiotherapy. For endoscopic release, the CTS Relief Kit (Linvatec. Largo, FL, USA) and a standard 4mm 30° arthroscope were used.

Results The study included 39 patients, 29 (74.4%) males and 10 (25.6%) females. The age of the patients ranged from 12 to 64 years (33 ± 14.97). Five patients underwent bilateral release. The release demonstrated a statistically significant improvement in pain (p 0.002), in sensitivity (p < 0.001), and in strength (p < 0.001). The best results were obtained when ulnar release was performed less than 6 months after surgery indication. None of the procedures were converted from endoscopic to open. No major complications (infection, vascular injury, and nervous injury) were reported. One patient had ulnar nerve subluxation.

Conclusion The endoscopic release of the ulnar nerve at the elbow in leprosy neuritis entails true and safe benefits for the patient, such as improvement in pain, sensitivity and strength.

Keywords

endoscopy - ulnar neuropathies - leprosy

Financial Support

There was no financial support from public, commercial, or non-profit sources.


Work developed at the National Reference Center in Dermatology, Sanitaria Dona Libânia, Fortaleza, CE, Brazil.




Publication History

Received: 04 June 2021

Accepted: 22 November 2021

Article published online:
15 February 2022

© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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