Comparison of Cubital Tunnel Syndrome with or without Anconeus Epitrochlearis: Are They Different?

Yoon,  Min Geun; Yoo,  Myung Jae; Kim,  Jong Min; Paeng,  Jung Wook; Kim,  Young Woo; Woo,  Sang Hyun

doi:2016.21.1.8

Arch Hand Microsurg > Volume 21(1); 2016 > Article

Original Article

Journal of the Korean Society for Surgery of the Hand 2016;21(1):8-15.
Published online March 31, 2016.
DOI: https://doi.org/10.12790/jkssh.2016.21.1.8

Comparison of Cubital Tunnel Syndrome with or without Anconeus Epitrochlearis: Are They Different?

Min Geun Yoon, Myung Jae Yoo, Jong Min Kim, Jung Wook Paeng, Young Woo Kim, Sang Hyun Woo

¹Department of Orthopedic Surgery, Cheju Halla General Hospital, Jeju, Korea.
²W Institute for Hand and Reconstructive Microsurgeyr, W Hospital, Daegu, Korea. handwoo@hotmail.com

Received: 12 September 2015 • Revised: 27 December 2015 • Accepted: 7 January 2016

Abstract

Purpose
To assess the clinical difference between cubital tunnel syndrome with anconeus epitrochlearis (AE) and idiopathic cubital tunnel syndrome without known other causes.

Methods
This cross-sectional study included the 326 patients who were subjected to surgery because of cubital tunnel syndrome from 2008 to 2014. After exclusion of patients with other known causes of cubital tunnel syndrome, a total of 107 patients were divided into two groups; patients with and without AE. The clinical differences between two groups were analyzed retrospectively; age, sex, presence of intrinsic muscle atrophy, interval from symptom development to surgery, pinch power, the disabilities of the arm, shoulder and hand score and the nerve conduction velocity (NCV).

Results
Thirty four (10.4%) patients, being subjected to surgery had the AE. Among 107 patients who had no other known causes, 26 patients had AE. 19 out of 26 patients with AE was male. Average age of patients with AE was significantly younger. The interval from symptom development to surgery in AE patients was significantly shorter. Motor NCV of ulnar nerve at above elbow joint in comparison with that at below elbow joint in AE patient was more significantly decreased (14.3 m/sec vs. 8.3 m/sec).

Conclusion
The AE in cubital tunnel syndrome is no more rare structure. In younger male patients with rapidly progressive worsening cubital tunnel symptoms, and if there is significant decrease of ulnar motor nerve velocity at above elbow in comparison with at below elbow, the AE should be considered as cause of ulnar neuropathy.