Super-Turbocharged End-to-Side Nerve Transfer for Severe Cubital Tunnel Syndrome: Preliminary Results.

BACKGROUND

Severe cubital tunnel syndrome (CuTS) is a common peripheral nerve compression disorder. Recent literature suggests that super-turbocharged end-to-side nerve transfer (STETS), which adds a transfer from the abductor digiti minimi (ADM) branch, may further enhance the recovery of intrinsic muscle function. This study aimed to evaluate the clinical efficacy of STETS for severe CuTS and compare its outcomes with those of SETS, particularly in restoring intrinsic hand motor function.

METHODS

This retrospective study included 14 patients with severe CuTS who underwent STETS and 10 who underwent SETS between January 2022 and August 2023. Ulnar nerve function was evaluated at 3 months, 12 months, and over 18 months postoperatively using the modified McGowan grading system, QuickDASH score, electromyography, two-point discrimination and manual muscle testing. Comparative analyses were performed between the two groups at each time point.

RESULTS

The final analysis included 24 patients (mean age 56.88 ± 10.98 years) with at least 18 months of follow-up. At over 18 months postoperatively, both groups showed significant improvement in the QuickDASH score, first dorsal interosseous muscle strength and ulnar nerve conduction velocity at the elbow compared to preoperative values (p < 0.05). The pinch strength in both groups improved compared with the preoperative values, and no significant difference was observed between the groups (p > 0.05).

CONCLUSION

STETS demonstrated a non-inferior trend compared with SETS in several functional outcomes, but without statistically significant differences. Its definitive efficacy requires further validation through large-sample, prospective controlled studies.Clinical Relevance Statement: This study directly compares the STETS and SETS nerve transfer techniques and provides evidence that STETS demonstrated a non-inferior trend compared with SETS in several functional outcomes. These findings support the use of STETS as an effective surgical option for improving motor outcomes in patients with severe cubital tunnel syndrome.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.