Visualization during endoscopic vs. open cubital tunnel decompression: A cadaveric study

Backhrounds: To determine the minimum incision size needed utilizing an opencubital tunnel technique to obtain equivalent and adequate visualization comparableto endoscopic technique.Methods:On ten fresh-frozen cadavers with a -2cm incision, visualization was assessedby percutaneous needle localization using the endoscopic system. The most proximaland distal extent of field of view was marked. Next, an open cubital tunnel release wasperformed on each cadaver specimen. The incision size was increased incrementallyand the most proximal and distal extents of visualization were recorded for eachincision size. The mean visualization distance and standard deviation for each incisionallength was calculated.Results: The mean proximal field of view with the endoscopic technique was 8.1 cm.The mean distal field of view was 8.3 cm. Using the open technique a -2cm incisionallowed 5.9 cm visualization proximally and 5.2 cm distally, which was significantlyless than the endoscopic view. A -4cm open incision provided similar visualization asthe endoscopic technique. A -6cm open incision was required to obtain statisticallysignificant improvements in visualization compared to endoscopic.Conclusions: A -4cm open incision was required to obtain equivalent visualizationto the endoscopic technique for cubital tunnel release. Incision of 6cm is required tovisualize 10cm proximal and distal to the medial epicondyle.