Endoscopic cubital releaseEndoscopic cubital releaseFinancial interestFinancial interest
Endoscopic cubital releaseEndoscopic cubital releaseFinancial interestFinancial interest
InventorInventorStock holderStock holder
InventorInventorStock holderStock holder
Endoscopic cubital tunnel Endoscopic cubital tunnel releaserelease
Endoscopic cubital tunnel Endoscopic cubital tunnel releaserelease
Treatment of cubital tunnel Treatment of cubital tunnel syndromesyndromeConservative treatmentConservative treatmentSurgical optionsSurgical options
Open cubital tunnel releaseOpen cubital tunnel releaseAnterior transposition of ulna nerveAnterior transposition of ulna nerve
SubmuscularSubmuscularSubcutanoeousSubcutanoeous
Medial epicondylectomyMedial epicondylectomy
Treatment of cubital tunnel Treatment of cubital tunnel syndromesyndromeConservative treatmentConservative treatmentSurgical optionsSurgical options
Open cubital tunnel releaseOpen cubital tunnel releaseAnterior transposition of ulna nerveAnterior transposition of ulna nerve
SubmuscularSubmuscularSubcutanoeousSubcutanoeous
Medial epicondylectomyMedial epicondylectomy
Endoscopic cubital tunnel Endoscopic cubital tunnel releaserelease
Endoscopic cubital tunnel Endoscopic cubital tunnel releaserelease
Platt in Br J Surg, 1926Platt in Br J Surg, 1926Anterior transposition of ulna nerveAnterior transposition of ulna nerve
Widely practiced todayWidely practiced todayProblemsProblems
Dissections and mobilization of the Dissections and mobilization of the ulna Nulna N
Platt in Br J Surg, 1926Platt in Br J Surg, 1926Anterior transposition of ulna nerveAnterior transposition of ulna nerve
Widely practiced todayWidely practiced todayProblemsProblems
Dissections and mobilization of the Dissections and mobilization of the ulna Nulna N
Endoscopic cubital tunnel Endoscopic cubital tunnel releaserelease
Endoscopic cubital tunnel Endoscopic cubital tunnel releaserelease
Problems with dissection and Problems with dissection and mobilizationmobilizationInterfering with the blood supplyInterfering with the blood supplyCompromising articular branchesCompromising articular branchesCompromising muscular branchesCompromising muscular branchesJeopardizing antebrachial cutaneous Jeopardizing antebrachial cutaneous
nervesnervesCreates large area of scar bedCreates large area of scar bed
Problems with dissection and Problems with dissection and mobilizationmobilizationInterfering with the blood supplyInterfering with the blood supplyCompromising articular branchesCompromising articular branchesCompromising muscular branchesCompromising muscular branchesJeopardizing antebrachial cutaneous Jeopardizing antebrachial cutaneous
nervesnervesCreates large area of scar bedCreates large area of scar bed
Endoscopic cubital tunnel Endoscopic cubital tunnel releaserelease
Endoscopic cubital tunnel Endoscopic cubital tunnel releaserelease
Regional blood flow to the UNRegional blood flow to the UNSmith 1966, Arch. Surg. Smith 1966, Arch. Surg.
5-8cm detachment of mesoneurium5-8cm detachment of mesoneuriumImpaired segmental circulationImpaired segmental circulationNot maintained anastomotic channelsNot maintained anastomotic channels
Regional blood flow to the UNRegional blood flow to the UNSmith 1966, Arch. Surg. Smith 1966, Arch. Surg.
5-8cm detachment of mesoneurium5-8cm detachment of mesoneuriumImpaired segmental circulationImpaired segmental circulationNot maintained anastomotic channelsNot maintained anastomotic channels
Endoscopic cubital tunnel Endoscopic cubital tunnel releaserelease
Endoscopic cubital tunnel Endoscopic cubital tunnel releaserelease
Regional blood flow to the UNRegional blood flow to the UNK Ogata and Manske 1984, Cl Orth R K Ogata and Manske 1984, Cl Orth R
ResearchResearchVascular injection studiesVascular injection studiesAnterior transposition associated with Anterior transposition associated with
significant decrease in blood flowsignificant decrease in blood flow
Regional blood flow to the UNRegional blood flow to the UNK Ogata and Manske 1984, Cl Orth R K Ogata and Manske 1984, Cl Orth R
ResearchResearchVascular injection studiesVascular injection studiesAnterior transposition associated with Anterior transposition associated with
significant decrease in blood flowsignificant decrease in blood flow
Endoscopic cubital tunnel Endoscopic cubital tunnel releaserelease
Endoscopic cubital tunnel Endoscopic cubital tunnel releaserelease
GoalsGoalsMinimize extensive soft tissue Minimize extensive soft tissue
dissectionsdissectionsMinimize manipulation of the nerveMinimize manipulation of the nerveMinimize mobilization of the nerveMinimize mobilization of the nervePreserve the mesoneuriumPreserve the mesoneurium
GoalsGoalsMinimize extensive soft tissue Minimize extensive soft tissue
dissectionsdissectionsMinimize manipulation of the nerveMinimize manipulation of the nerveMinimize mobilization of the nerveMinimize mobilization of the nervePreserve the mesoneuriumPreserve the mesoneurium
Endoscopic cubital tunnel Endoscopic cubital tunnel releaserelease
Endoscopic cubital tunnel Endoscopic cubital tunnel releaserelease
ECUTR may be the answerECUTR may be the answerECUTR may be the answerECUTR may be the answer
QuickTime™ and a decompressor
are needed to see this picture.
Endoscopic cubital tunnel Endoscopic cubital tunnel releaserelease
Endoscopic cubital tunnel Endoscopic cubital tunnel releaserelease
instrumentationinstrumentationinstrumentationinstrumentation
Compliments of AMS
Clear cannulaClear cannulaClear cannulaClear cannula
360 degree visualization360 degree visualization360 degree visualization360 degree visualization
Endoscopic cubital tunnel Endoscopic cubital tunnel releaserelease
Endoscopic cubital tunnel Endoscopic cubital tunnel releaserelease
StandardStandard4mm scope4mm scopeLocking deviceLocking deviceSleeve knifeSleeve knife
StandardStandard4mm scope4mm scopeLocking deviceLocking deviceSleeve knifeSleeve knife
Compliments of AMS
Land MarksLand MarksLand MarksLand Marks LandmarksLandmarks
Med. EpicondyleMed. Epicondyle OlecrenonOlecrenon 3-5 cm incision3-5 cm incision
LandmarksLandmarks Med. EpicondyleMed. Epicondyle OlecrenonOlecrenon 3-5 cm incision3-5 cm incision
Surgical techniqueSurgical techniqueSurgical techniqueSurgical technique IncisionIncision LandmarksLandmarks
Med. EpicondyleMed. Epicondyle OlecrenonOlecrenon 3-5 cm incision3-5 cm incision
IncisionIncision LandmarksLandmarks
Med. EpicondyleMed. Epicondyle OlecrenonOlecrenon 3-5 cm incision3-5 cm incision
Surgical techniqueSurgical techniqueSurgical techniqueSurgical technique
Division Osborns ligamentDivision Osborns ligament Identification of Ant. Br. Cut. NerveIdentification of Ant. Br. Cut. Nerve Identification of unla nerveIdentification of unla nerve
Division Osborns ligamentDivision Osborns ligament Identification of Ant. Br. Cut. NerveIdentification of Ant. Br. Cut. Nerve Identification of unla nerveIdentification of unla nerve
Surgical techniqueSurgical techniqueSurgical techniqueSurgical technique
Distal dissectionDistal dissectionClamp or scissor dissectionClamp or scissor dissection
Distal dissectionDistal dissectionClamp or scissor dissectionClamp or scissor dissection
Surgical techniqueSurgical techniqueSurgical techniqueSurgical technique
Distal dissectionDistal dissectionDissectorDissector
Distal dissectionDistal dissectionDissectorDissector
Surgical techniqueSurgical techniqueSurgical techniqueSurgical technique Follow the pathwayFollow the pathway Created by dissectorCreated by dissector Obturator cannula assemblyObturator cannula assembly Remove the obturatorRemove the obturator
Follow the pathwayFollow the pathway Created by dissectorCreated by dissector Obturator cannula assemblyObturator cannula assembly Remove the obturatorRemove the obturator
Endoscopic VisualizationEndoscopic Visualization&&
DivisionDivision
Endoscopic VisualizationEndoscopic Visualization&&
DivisionDivision
Surgical techniqueSurgical techniqueSurgical techniqueSurgical technique Arthroscope 4mm 30 degreeArthroscope 4mm 30 degree Visualize Visualize Knife sleeve assemblyKnife sleeve assembly DivisionDivision
Arthroscope 4mm 30 degreeArthroscope 4mm 30 degree Visualize Visualize Knife sleeve assemblyKnife sleeve assembly DivisionDivision
Surgical techniqueSurgical technique Endoscopic visualizationEndoscopic visualizationSurgical techniqueSurgical technique Endoscopic visualizationEndoscopic visualization
Surgical TechniqueSurgical TechniqueSurgical TechniqueSurgical Technique
Fix Knife to EndoscopeFix Knife to Endoscope Slide knife over Slide knife over
scopescope Lock Knife in placeLock Knife in place
Fix Knife to EndoscopeFix Knife to Endoscope Slide knife over Slide knife over
scopescope Lock Knife in placeLock Knife in place
Surgical techniqueSurgical technique Endoscopic visualizationEndoscopic visualizationSurgical techniqueSurgical technique Endoscopic visualizationEndoscopic visualization
Surgical TechniqueSurgical TechniqueSurgical TechniqueSurgical TechniqueProximal DissectionProximal DissectionProximal DissectionProximal Dissection
Surgical TechniqueSurgical TechniqueSurgical TechniqueSurgical TechniqueProximal insertion of Proximal insertion of
obturator cannulaobturator cannulaProximal insertion of Proximal insertion of
obturator cannulaobturator cannula
Endoscopic visualizationEndoscopic visualizationEndoscopic visualizationEndoscopic visualization
Surgical TechniqueSurgical TechniqueSurgical TechniqueSurgical Technique
Endoscopic VisualizationEndoscopic VisualizationArcade of StruthersArcade of Struthers
Endoscopic VisualizationEndoscopic VisualizationArcade of StruthersArcade of Struthers
If nerve subluxes on flexionIf nerve subluxes on flexionMedial epicondyletomyMedial epicondyletomyAnterior transposition Anterior transposition
If nerve subluxes on flexionIf nerve subluxes on flexionMedial epicondyletomyMedial epicondyletomyAnterior transposition Anterior transposition
Surgical techniqueSurgical techniqueSurgical techniqueSurgical technique
QuickTime™ and a decompressor
are needed to see this picture.
ResultsResultsResultsResults
17 patients17 patients 6 Females6 Females 11 Males11 Males
17 patients17 patients 6 Females6 Females 11 Males11 Males
ResultsResultsResultsResults
2 pt. underwent Med. 2 pt. underwent Med. EpicondylectomyEpicondylectomy
1 pt. had anterior 1 pt. had anterior transpositiontransposition
2 pt. underwent Med. 2 pt. underwent Med. EpicondylectomyEpicondylectomy
1 pt. had anterior 1 pt. had anterior transpositiontransposition
ResultsResultsResultsResults
ComplicationsComplications2 haematomas2 haematomasNo ulna nerve injuryNo ulna nerve injuryNo injury to M A B cutaneous nerveNo injury to M A B cutaneous nerveNo recurrenceNo recurrence1 hypertrophic scar1 hypertrophic scar
ComplicationsComplications2 haematomas2 haematomasNo ulna nerve injuryNo ulna nerve injuryNo injury to M A B cutaneous nerveNo injury to M A B cutaneous nerveNo recurrenceNo recurrence1 hypertrophic scar1 hypertrophic scar
ResultsResultsResultsResults
Tsai et alTsai et al endoscopic cubital tunnel endoscopic cubital tunnel
85 elbows in 76 patients 85 elbows in 76 patients 32 months follow up32 months follow up 42% had excellent results, 45% had good results, 42% had excellent results, 45% had good results,
11% had fair results, and 2% had poor results. 11% had fair results, and 2% had poor results. ConclusionConclusion
These results are comparable to the other These results are comparable to the other decompressive techniques, which overall result in decompressive techniques, which overall result in 85-90% good-to-excellent results.85-90% good-to-excellent results.
Tsai et alTsai et al endoscopic cubital tunnel endoscopic cubital tunnel
85 elbows in 76 patients 85 elbows in 76 patients 32 months follow up32 months follow up 42% had excellent results, 45% had good results, 42% had excellent results, 45% had good results,
11% had fair results, and 2% had poor results. 11% had fair results, and 2% had poor results. ConclusionConclusion
These results are comparable to the other These results are comparable to the other decompressive techniques, which overall result in decompressive techniques, which overall result in 85-90% good-to-excellent results.85-90% good-to-excellent results.
ResultsResultsResultsResults
Hoffmann et alHoffmann et al 75 patients (76 cases).75 patients (76 cases).Release the U nerve release 17 cm Release the U nerve release 17 cm Incision averaging 2.8 cm in length. Incision averaging 2.8 cm in length. The mean follow-up 11 months The mean follow-up 11 months Good to excellent results in 94% of Good to excellent results in 94% of
patients. patients.
Hoffmann et alHoffmann et al 75 patients (76 cases).75 patients (76 cases).Release the U nerve release 17 cm Release the U nerve release 17 cm Incision averaging 2.8 cm in length. Incision averaging 2.8 cm in length. The mean follow-up 11 months The mean follow-up 11 months Good to excellent results in 94% of Good to excellent results in 94% of
patients. patients.
ConclusionsConclusionsConclusionsConclusions
Minimally invasiveMinimally invasive No manipulation of the nerve No manipulation of the nerve No interruption of blood supplyNo interruption of blood supply Avoids sacrifice of the Avoids sacrifice of the
articular/muscular Br.articular/muscular Br.
Minimally invasiveMinimally invasive No manipulation of the nerve No manipulation of the nerve No interruption of blood supplyNo interruption of blood supply Avoids sacrifice of the Avoids sacrifice of the
articular/muscular Br.articular/muscular Br.
New DesignNew DesignNew DesignNew Design Winged Design Winged Design Will open and close the slot at any time and then lock into placeWill open and close the slot at any time and then lock into place Protect the nerve and gently move it from the cutting bladeProtect the nerve and gently move it from the cutting blade Will be out in Four WeeksWill be out in Four Weeks
Winged Design Winged Design Will open and close the slot at any time and then lock into placeWill open and close the slot at any time and then lock into place Protect the nerve and gently move it from the cutting bladeProtect the nerve and gently move it from the cutting blade Will be out in Four WeeksWill be out in Four Weeks
QuickTime™ and a decompressor
are needed to see this picture.
QuickTime™ and a decompressor
are needed to see this picture.
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