Submuscular transposition with musculofascial lengthening for persistent or recurrent cubital tunnel syndrome in 34 patients

The two main surgical options for patients with persistent or recurrent cubital tunnel syndrome are subcutaneous and submuscular transposition. We retrospectively analysed the results of 34 patients with recalcitrant cubital tunnel syndrome who underwent submuscular transposition with musculofascial lengthening at our institutions. Of the 34 patients, 21 improved clinically after submuscular transposition with musculofascial lengthening, of which 16 were still satisfied at a mean follow-up of four years. In addition, all articles published between 1974 and January 2015 on subcutaneous and/or submuscular transposition of the ulnar nerve for recalcitrant cubital tunnel syndrome were reviewed. We found that previously published studies on this subject are too heterogeneous to compare. No recommendation can thus be made regarding the surgical technique for persistent or recurrent cubital tunnel syndrome. Our series shows that the musculofascial lengthening technique for submuscular transposition is a good option. More research is needed to compare the different surgical treatments. Level of evidence: IV.