Clin Orthop Surg.  2018 Sep;10(3):352-357. 10.4055/cios.2018.10.3.352.

Accuracy of Preoperative Ultrasonography for Cubital Tunnel Syndrome: A Comparison with Intraoperative Findings

• Cho CH
• Lee YH
• Song KS
• Lee KJ
• Lee SW
• Lee SM

• KMID: 2418756
• DOI: http://doi.org/10.4055/cios.2018.10.3.352

Abstract

BACKGROUND
The aim of this study was to assess the consistency between preoperative ultrasonographic and intraoperative measurements of the ulnar nerve in patients with cubital tunnel syndrome.
METHODS
Twenty-six cases who underwent anterior transposition of the ulnar nerve for cubital tunnel syndrome were enrolled prospectively. On preoperative ultrasonography, largest cross-sectional diameters of the ulnar nerve were measured at the level of medial epicondyle (ME) and 3 cm proximal (PME) and distal (DME) to the ME on the transverse scan by a single experienced radiologist. Intraoperative direct measurements of the largest diameter at the same locations were performed by a single surgeon without knowledge of the preoperative values. The consistency between ultrasonographic and intraoperative values including the largest diameter and swelling ratio were assessed.
RESULTS
Significant differences between ultrasonographic and intraoperative values of the largest diameter were found at all levels. The mean difference was 1.29 mm for PME, 1.38 mm for ME, and 1.12 mm for DME. The mean ME-PME swelling ratio for ultrasonographic and intraoperative measurements was 1.50 and 1.39, respectively, showing significant difference. The mean ME-DME swelling ratio for ultrasonographic and intraoperative measurements was 1.53 and 1.43, respectively, showing no significant difference.
CONCLUSIONS
Ultrasonographically measured largest diameters of the ulnar nerve at any levels were smaller than the real values determined intraoperatively. The ME-DME swelling ratio of the ulnar nerve measured by ultrasonography was consistent with the intraoperative measurement.

Keyword

Ulnar nerve; Cubital tunnel syndrome; Ultrasonography

MeSH Terms

Cubital Tunnel Syndrome*
Humans
Prospective Studies
Ulnar Nerve
Ultrasonography*

Figure

• 

  Fig. 1 Ultrasonographic findings. (A) A normal ulnar nerve (largest diameter, 4.1 mm) at 3 cm proximal to the medial epicondyle. (B) Focal enlargement of the ulnar nerve (largest diameter, 7.0 mm) at the level of the medial epicondyle. (C) A normal ulnar nerve (largest diameter, 4.3 mm) at 3 cm distal to the medial epicondyle.

• 

  Fig. 2 Intraoperative findings. (A) Focal enlargement of the ulnar nerve. (B) Measurement of the largest diameter of the ulnar nerve at the level of the medial epicondyle using a caliper.

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