Comparing the Outcomes Between Minimal Incision Endoscopic Cubital Tunnel Release and Open Cubital Tunnel Release: A Prospective Randomized Controlled Trial.

Cubital tunnel syndrome is the second most common peripheral nerve entrapment in the upper extremity requiring surgical intervention. While endoscopic decompression techniques have gained popularity due to presumed faster recovery and reduced morbidity, data comparing long-term outcomes remain limited. This study introduces a novel minimal incision endoscopic cubital tunnel release (MICuR) technique and evaluates its efficacy against conventional open cubital tunnel release (OCuTR). In this prospective randomized controlled trial, 30 patients with moderate to severe cubital tunnel syndrome were randomized to undergo either MICuR (n=15) or OCuTR (n=15). Postoperative outcomes were assessed at multiple intervals up to six months and included postoperative pain (Visual Analog Scale (VAS)), functional recovery (modified Bishop score), scar sensitivity (Modified Vancouver Scar Scale (mVSS)), time to return to work, and complications. The results of this study showed that MICuR significantly reduced early postoperative pain compared to OCuTR, with VAS scores of 0.8 vs. 4.7 on postoperative day 1 (p<0.01) and consistently lower pain scores through day 6 (all p<0.01). Time to return to work was markedly shorter in the MICuR group (two days vs. 13 days; p<0.01). Scar sensitivity was also significantly reduced at one, three, and six months (p<0.01). Functional recovery, as measured by the modified Bishop score, was comparable between groups at all timepoints. No significant differences in complication rates were observed. In conclusion, MICuR offers superior short-term outcomes in terms of pain control, scar sensitivity, and return to work, without compromising functional recovery or increasing complications. These findings support MICuR as a promising alternative for patients seeking rapid recovery and improved cosmetic outcomes.