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Correlation between preoperative Kimura inching studies and intraoperative findings during endoscopic-assisted decompression of the ulnar nerve at the elbow

  • Surgery Articles
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HAND

Abstract

Background

During the evolution of the senior author's technique of ulnar nerve transposition to in situ decompression for ulnar neuropathy at the elbow, nerve conduction studies (NCS) including the Kimura inching method were performed preoperatively in an effort to ensure that all potential sites of compression were investigated intraoperatively. The purpose of this study is to compare the results of the Kimura inching technique with the intraoperative findings noted during decompression of the ulnar nerve at the elbow.

Methods

The medical records of consecutive patients who underwent in situ decompression of their ulnar nerves combined with endoscopic examination between March and December of 2009 were retrospectively reviewed. The site of ulnar nerve compression noted using the Kimura inching technique was compared with the intraoperative findings.

Results

Twelve consecutive patients (four with bilateral symptoms) underwent endoscopic ulnar nerve compression in the study period for a total of 16 cases analyzed. In 12 cases, the Kimura method localized the site of compression to Osborne's bands and/or the aponeurosis of the flexor carpi ulnaris (FCU). Intraoperatively, compression was noted at Osborne's bands, the FCU aponeurosis, and/or the FCU) muscle proper in all 16 patients. There was partial or full correlation between the nerve conduction data and intraoperative findings in 13/16 cases.

Conclusions

There was good but not perfect agreement between the NCS and intraoperative findings, perhaps because transcutaneous NCS are less accurate when a nerve is surrounded by muscle. The information obtained in this study is valuable when planning surgery to address ulnar nerve compression.

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Conflict of interest

The authors have no financial disclosures or grant support to declare.

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Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, Department of Surgery, Northwestern University, 675 N. St. Clair Ave, Galter Suite 19-250, Chicago, IL, 60610, USA

    Sonya Paisley Agnew

  2. Department of Neurology, Northwestern University, 201 E. Huron Galter 11-100, Chicago, IL, 60611, USA

    Michael M. Minieka

  3. Department of Orthopaedic Surgery, Northwestern University, 676 N. Saint Clair Suite 1350, Chicago, IL, 60611, USA

    Ronak M. Patel

  4. Department of Orthopaedic Surgery, Northwestern University, 737 N. Michigan Ave. #700, Chicago, IL, 60611, USA

    Daniel J. Nagle

Authors
  1. Sonya Paisley Agnew
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  2. Michael M. Minieka
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  3. Ronak M. Patel
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  4. Daniel J. Nagle
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Corresponding author

Correspondence to Sonya Paisley Agnew.

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Agnew, S.P., Minieka, M.M., Patel, R.M. et al. Correlation between preoperative Kimura inching studies and intraoperative findings during endoscopic-assisted decompression of the ulnar nerve at the elbow. HAND 7, 370–373 (2012). https://doi.org/10.1007/s11552-012-9460-y

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  • DOI: https://doi.org/10.1007/s11552-012-9460-y

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