Cubital tunnel syndrome (Ulnar nerve entrapment) in University Hospital Hamburg-Eppendorf

About the department

The Department of Adult and Pediatric Orthopedics at the University Hospital Hamburg-Eppendorf provides a full range of diagnostic and treatment services for musculoskeletal disorders in patients of all ages. The medical facility offers patients the highest standards of healthcare service, experienced physicians, state-of-the-art equipment, the very latest treatment methods, and personalized care. The department's team of doctors specializes in joint replacement surgery (hip, knee, shoulder, elbow, and ankle arthroplasty), including revision surgery to replace previously implanted prostheses, treatment of bone and joint infections, bone and joint necrosis, joint-preserving surgery for dysplasia and hip dislocation, treatment of rheumatic joint lesions, foot and ankle pathologies, spinal diseases, and bone tumors. The medical facility also treats young patients with orthopedic diseases with a special emphasis on the treatment of hip dysplasia, Perthes disease, clubfoot, flatfoot, and scoliosis. The department's specialists also have successful experience in the treatment of rare orthopedic diseases, including hemophilic arthropathy and osteogenesis imperfecta. Medical services are provided in accordance with the recommendations of the German Society for Orthopedics and Trauma Surgery (DGOU) and the German Society for Orthopedics and Orthopedic Surgery (DGOOC). The Head Physician is Prof. Dr. med. Frank Timo Beil.

Large joint replacement surgery is one of the primary clinical responsibilities of the department's medical team. Specialists perform partial and total hip, knee, shoulder, elbow, and ankle arthroplasty. This surgical procedure is indicated for patients with arthrosis, severe rheumatic joint lesions, joint degeneration due to hip dysplasia, O-shaped and X-shaped lower limb deformities, avascular necrosis of the femoral head, osteogenesis imperfecta, hemophilic arthropathy, and other pathologies. The therapeutic process begins with an individual consultation with an orthopedist, after which the patient is prescribed a series of diagnostic measures to assess the indications for joint replacement surgery with a prosthesis. This is followed by the stage of surgical planning, including the choice of the type of joint replacement surgery (partial or total), the optimal surgical approach, the type of endoprosthesis – it can also be custom-made taking into account the individual anatomical features of the patient if necessary. Joint replacement surgery is performed using minimally invasive approaches and innovative computer-assisted and navigation systems that allow for the most accurate positioning of the prosthesis to ensure its optimal function. A major advantage of minimally invasive arthroplasty is the rapid restoration of mobility in the postoperative period. In addition, surgical risks are significantly reduced, and the patient experiences virtually no pain after surgery. Experienced physiotherapists and rehabilitation specialists take care of the patient after surgery.

Specialists at the medical facility also regularly perform arthroscopic procedures on the hip, knee, shoulder, elbow, and ankle joints. Arthroscopy is a minimally traumatic surgery that requires only 2-3 incisions 5-6 mm long for surgical approach. During the procedure, a special instrument (arthroscope) with a built-in miniature camera is used to transmit the image of the inside of the affected joint to a large monitor in real time with multiple zooms. Arthroscopy is performed under local anesthesia, and the risks for the patient are practically zero. The department's team of orthopedic surgeons most often uses arthroscopy to treat the early stages of arthrosis, joint instability, impingement syndrome, knee ligament injuries, meniscus injuries, rotator cuff injuries, and cartilage lesions.

The department has a reputation as one of the leading healthcare facilities in Germany for the treatment of bone and soft tissue sarcomas. It has a specialized Sarcoma Center that is integrated into the University Cancer Center Hamburg (UCCH). The diagnostic phase includes a review of the patient's medical history, a clinical examination, laboratory tests, imaging studies, and a biopsy. A treatment regimen is developed in cooperation with oncologists, radiation therapists, and radiologists. The decisive factor in choosing the treatment tactics is the type of tumor: for example, the department's specialists successfully use radiofrequency ablation to remove an osteoid osteoma (a benign tumor), which is a minimally invasive procedure performed under short-acting anesthesia; if the patient is diagnosed with osteosarcoma, Ewing's sarcoma, or chondrosarcoma (malignant neoplasms), an open tumor resection surgery is most often performed. The department's team of physicians also performs reconstructive bone surgery following the removal of large tumors.

The main clinical focuses of the department are the following:

• Conservative and surgical treatment of hip, knee, shoulder, elbow, and ankle arthrosis
• Conservative and surgical treatment of bone and joint infectious lesions
• Conservative and surgical treatment of bone and joint necrosis
• Conservative and surgical treatment of rheumatic lesions of the musculoskeletal system
• Conservative and surgical treatment of spinal diseases
• Conservative and surgical treatment of rare orthopedic diseases, including hemophilic arthropathy and osteogenesis imperfecta
• Conservative and surgical treatment of pediatric orthopedic diseases: hip dysplasia, Perthes disease, clubfoot, flatfoot, and scoliosis
• Conservative and surgical treatment of other orthopedic diseases

The range of therapeutic options offered by the department includes the following:

• Conservative treatment
  • Drug therapy with pills
  • Treatment with orthoses and other orthopedic aids
  • Intra-articular injections
  • Therapeutic exercises
  • Physiotherapy
• Surgical treatment
  • Arthroscopic interventions
  • Minimally invasive interventions
  • Microsurgical interventions
  • Reconstructive interventions
  • Lower and upper limb amputation
• Other treatment methods