Compact Ultra-Wideband Wilkinson Power Divider in Parallel Stripline with Modified Isolation Branches.

An efficient design method for a compact and ultra-wideband multi-stage Wilkinson power divider in a parallel stripline (PSL) is proposed. To enhance the frequency bandwidth of the proposed power divider while reducing its size, the isolation branch is modified; that is, two capacitors are connected to both sides of a resistor at each isolation branch. For an efficient design process, the PSL power divider is equivalently represented by two microstrip power dividers, and the design equations are derived. Based on the design equations, an in-house algorithm is utilized to optimally determine the design parameters, including the line impedance, resistance, and capacitance of each stage. For example, a three-stage PSL power divider is designed with three λ/4 transmission lines at a base frequency of 5 GHz. To verify the accuracy of the design procedure, 3D EM simulations and measurements are performed, and the results show good agreement. Compared with the conventional three-stage Wilkinson power divider, the proposed PSL power divider achieves a wider frequency bandwidth of 1.16 to 6.51 GHz (139.5%) and a 23% shorter transmission line length of 207°, while exhibiting an insertion loss of 0.7 to 1.4 dB.

Ultra-Wideband Vertical Transition in Coplanar Stripline for Ultra-High-Speed Digital Interfaces.

A design method for an ultra-wideband coplanar-stripline-based vertical transition that can be used for ultra-high-speed digital interfaces is proposed. A conventional via structure, based on a differential line (DL), inherently possesses performance limitations (<10 GHz) due to difficulties in maintaining constant line impedance and smooth electric field transformation, in addition to the effects of signal skews, FR4 fiber weave, and unbalanced EM interferences. DL-based digital interfaces may not meet the demands of ultra-high-speed digital data transmission required for the upcoming 6G communications. The use of a coplanar stripline (CPS), a type of planar balanced line (BL), for the vertical transition, along with the ultra-wideband DL-to-CPS transition, mostly removes the inherent and unfavorable issues of the DL and enables ultra-high-speed digital data transmission. The design process of the transition is simplified using the analytical design formulas, derived using the conformal mapping method, of the transition. The characteristic line impedances of the transition are calculated and found to be in close agreement with the results obtained from EM simulations. Utilizing these results, the CPS-based vertical transition, maintaining the characteristic line impedance of 100 Ω, is designed and fabricated. The measured results confirm its ultra-wideband characteristics, with a maximum of 1.6 dB insertion loss and more than 10 dB return loss in the frequency range of DC to 30 GHz. Therefore, the proposed CPS-based vertical transition offers a significantly wider frequency bandwidth, i.e., more than three times that of conventional DL-based via structures.

Ultra-thin flexible rectenna integrated with power management unit for wireless power harvester/charging of smartwatch/wristband.

This paper proposes a circularly polarized ultra-thin flexible antenna with a flexible rectifier and power management unit (PMU) for smartwatch/wristband applications. The flexible antenna is compact (0.17λ0 × 0.20λ0 × 0.0004λ0) and has a stepped ground plane. A parasitic element is used at the substrate bottom to reduce the specific absorption rate (SAR) and enhance the gain up to 3.2 dBi, at the resonating frequency of WLAN/Wi-Fi (2.45 GHz). The SAR of the proposed design is also analysed at the resonating frequency, and it satisfies the guidelines of the International Commission on Non-Ionizing Radiation Protection (ICNIRP) and IEEE C95.1-2019 human safety standards. An impedance matching circuit is used between the antenna and the RF energy harvester to improve conversion efficiency. Polarization mismatch is avoided with the help of circular polarization, achieved by tuning stubs of size 0.02λ0 × 0.044λ0. The integration of the antenna and rectenna results in a good conversion efficiency of 78.2% at - 5 dBm of input power with a load resistance of 2 KΩ. The availability of RF signals allows the user to charge the smartwatch/wristband by connecting the PMU circuit with the RF energy harvester.

Compact Dual Circularly-Polarized Quad-Element MIMO/Diversity Antenna for Sub-6 GHz Communication Systems.

In this paper, a compact dual circularly-polarized (CP) planar multiple-input-multiple-output (MIMO) antenna is presented for a sub-6 GHz frequency band. The antenna consists of four identical resonating elements, which are placed in a mirrored-image pattern to obtain polarization diversity. Element 2 is a mirror image of element 1, and elements 3 and 4 are mirror images of elements 1 and 2. Each antenna element comprises an elliptical resonator, a 50-Ω microstrip feed line, and a rectangular stub integrated with the feed to increase the surface current path of the antenna, shifting the resonating frequency to the lower side. Additionally, the rectangular stub is lengthened towards the right side (along the +x-axis direction in the antenna element 1), which balances the magnitude and 90° phase variance among the horizontal (Ex) and vertical (Ey) fields. The proposed MIMO antenna supports both types of circular polarization, where radiators 1 and 3 radiate right-hand CP (RHCP) rays and radiators 2 and 4 radiate left-hand CP (LHCP) rays. Developing a compact-size MIMO antenna is a challenging task, especially when the antenna elements share the same ground plane and are placed less than half a wavelength apart. The mutual coupling in the proposed antenna is reduced by increasing the spacing between the elements without the use of any extra decoupling structure. Optimal spacing is maintained to achieve compact geometry with less inter-element correlation. The radiators are closely placed with an edge-to-edge spacing of 0.08λ0, where λ0 is the free space wavelength at 3.6 GHz. A peak gain of 5 dBi, efficiency of 90%, an envelope correlation coefficient (ECC) of less than 0.1, and isolation of more than 18 dB are obtained between different ports of the prototype antenna. The overall size of the antenna element is 17 mm × 17 mm × 1.6 mm, and the MIMO antenna is 40 mm × 40 mm × 1.6 mm.

Ultra-Wideband Differential Line-to-Balanced Line Transitions for Super-High-Speed Digital Transmission.

A conventional differential line (DL), commonly used on typical digital circuit boards for transmitting high-speed digital data, has fundamental limitations on the maximum signal bandwidth (~10 GHz), mainly due to signal skew, multiple line coupling, and EM interference. Therefore, to support super-high-speed digital data transmission, especially for beyond 5G communications, a practical high-performance transmission structure for digital signals is required. Balanced lines (BLs) can transmit the differential signals with multiple advantages of ultra-wide bandwidth, common-mode rejection, reduced crosstalk, phase recovery, and skew reduction, which enable super-high-speed transmission. In order to utilize the BLs in the DL-based digital circuit, connecting structures between a DL and BLs are required, but the DL-to-BL transition structures dominate the operating bandwidth and signal properties. Therefore, in this paper, properties, and design methods for two ultra-wideband DL-to-BL transitions, i.e., DL-to-CPS (coplanar stripline) and DL-to-PSL (parallel stripline) transitions, are presented. Both implemented DL-to-CPS and DL-to-PSL transitions provide high-quality performance up to 40 GHz or higher, significantly enhancing the frequency bandwidth for the transmission of digital signals while providing compatibility with the DL-based PCBs. The fabricated DL-to-CPS transition performs well from DC to 40 GHz with an insertion loss of less than 0.86 dB and a return loss of more than 10 dB, and the fabricated DL-to-PSL transition also provides good performance from DC to 40 GHz, with an insertion loss of less than 1.34 dB and a return loss of more than 10 dB. Therefore, the proposed DL-to-BL transitions can be applied to achieve super-high-speed digital data transmission with over 40 GHz bandwidth, which is more than four times the bandwidth of the DL, supporting over 200 Gbps of digital data transmission on PCBs for the next generation of advanced communications.

Stepwise evolution of a butterfly supergene via duplication and inversion.

Supergenes maintain adaptive clusters of alleles in the face of genetic mixing. Although usually attributed to inversions, supergenes can be complex, and reconstructing the precise processes that led to recombination suppression and their timing is challenging. We investigated the origin of the BC supergene, which controls variation in warning coloration in the African monarch butterfly, Danaus chrysippus. By generating chromosome-scale assemblies for all three alleles, we identified multiple structural differences. Most strikingly, we find that a region of more than 1 million bp underwent several segmental duplications at least 7.5 Ma. The resulting duplicated fragments appear to have triggered four inversions in surrounding parts of the chromosome, resulting in stepwise growth of the region of suppressed recombination. Phylogenies for the inversions are incongruent with the species tree and suggest that structural polymorphisms have persisted for at least 4.1 Myr. In addition to the role of duplications in triggering inversions, our results suggest a previously undescribed mechanism of recombination suppression through independent losses of divergent duplicated tracts. Overall, our findings add support for a stepwise model of supergene evolution involving a variety of structural changes. This article is part of the theme issue 'Genomic architecture of supergenes: causes and evolutionary consequences'.

Electrically Small Circularly Polarized UWB Intraocular Antenna System for Retinal Prosthesis.

OBJECTIVE: This paper presents the design of an electrically small circularly polarized (CP) 3 × 3 mm2 antenna system as an intraocular unit for retinal prosthesis application. METHODS: The system is operating in ISM and ultra-wideband (UWB) bands to target high programmability of retina stimulation and recording, respectively. The electrical dimensions, including the ground plane, are λ0/41 × λ0/41 × λ0/191. Physical limitations of the antenna are discussed based on Hansen and Collin's limitations. The proposed wire patch antenna exhibits wideband characteristics by combining multiple modes of the patch antenna in the presence of an interface PCB circuit. RESULTS: By loading polyimide encapsulated patch with stubs, dominant TM010 mode is combined with the higher order modes TM020-TM070 to exhibit wide -10 dB impedance bandwidth of 2-11 GHz. Annular rings and shorting pins in the ground plane provide CP radiation at 2.45, 5.8, and 8 GHz with 3-dB axial-ratio bandwidth of 0.3, 0.16, and 1.2 GHz, and far-field left hand circularly polarized (LHCP) gain of -18.4, -7.6, and -4.7 dBic, respectively, in broadside direction. A biocompatible antenna system is designed using Ansys HFSS in the presence of a detailed multilayer canonical eye model. Additionally, it is examined in an anatomical HFSS head model. Near and far-field electric field distribution is studied along with peak 1-g average specific absorption rate (SAR) calculations. CONCLUSION: The proposed antenna is fabricated, and the performance, including coupled power from an external antenna, is measured in a custom made eye model including head phantom. A reasonable agreement is obtained between simulated and measured results. SIGNIFICANCE: To generate an artificial vision, image perception capability could be improved with implantable UWB communication systems that feature particularly high data-rate and small size.

Dual Circularly Polarized Planar Four-Port MIMO Antenna with Wide Axial-Ratio Bandwidth.

A broadband compact-sized planar four-port multiple-input-multiple-output (MIMO) antenna with polarization diversity is presented. The proposed dual circularly polarized (CP) MIMO antenna consists of four G-shaped monopole elements, two of which are left-hand CP and the other two are right-hand CP. A vertical line strip in the G-shaped radiating element acts in balancing the vertical and horizontal electric field components to obtain 90° phase difference between them for circular polarization. Also, an I-shaped strip is incorporated between the ground planes of the G-shaped antenna elements to obtain equal voltage level in the proposed MIMO configuration. The dual circular polarization mechanism of the proposed MIMO/diversity antenna is analysed from the vector current distributions. The impedance bandwidth (S11 ≤ -10 dB) of the MIMO antenna is 105.9% (4-13 GHz) and the 3 dB axial ratio bandwidth (ARBW) is 67.7% (4.2-8.5 GHz), which is suitable for C-band applications. The overall size of the MIMO antenna is 70 × 68 × 1.6 mm3, and the minimum isolation between the resonating elements is 18 dB. The envelope correlation coefficient is less than 0.25, and the peak gain within the resonating band is 6.4 dBi.

Ultra-Miniature Circularly Polarized CPW-Fed Implantable Antenna Design and its Validation for Biotelemetry Applications.

The paper presents a coplanar waveguide (CPW)-fed ultra-miniaturized patch antenna operating in Industrial, Scientific and Medical (ISM) band (2.4-2.5 GHz) for biotelemetry applications. The proposed antenna structure is circular in shape and its ground plane is loaded with a pair of slots for obtaining circular polarization. In the proposed design, asymmetric square slots generate phase condition for right-hand circularly polarized (RHCP) radiation. And, by merely changing the position of the slots, either RHCP or left-hand circularly polarized (LHCP) radiation can be excited. In the proposed design, a meandered central strip is used for miniaturization. The simulations of the proposed antenna are carried out using Ansys HFSS software with a single-layer and multilayer human tissue models. The antenna shows good performance for different tissue properties owing to its wide axial ratio bandwidth and impedance bandwidth. The antenna is fabricated and measurements are carried out in skin mimicking phantom and pork. Simulated and measured performances of the antenna are in close agreement. The power link budget is also calculated using an exterior circularly polarized (CP) receiving antenna.

Compact low-loss narrow-band duplexer using low-impedance open-loop resonators for K-band radiometers.

Design and implementation of a low-loss K-band duplexer consisting of two narrow bandpass filters with low-impedance open-loop resonators (OLRs) is presented. Narrow bandpass filters of 4%-7% bandwidth were often implemented with OLRs, but previous designs used OLRs mostly with 50 Ω linewidth. The design process was complicated due to multiple coupling mechanisms and multiple spurious response frequencies, often resulting in excessive insertion loss, especially at higher center frequencies. With the proposed design procedure for OLR filters, the values of the low-impedance line (less than 50 Ω) and proper coupling spacing are determined in the process of optimizing the filter performance, resulting in low insertion loss up to above K-band frequencies. The size of the proposed filter is also reduced to 64% of the conventional OLR filters. As an example of the proposed design method, a duplexer consisting of 4% narrow bandpass filters centered at 18.7 GHz and 22.5 GHz was implemented and measured, and the maximum insertion loss in each passband was 1.2 dB, which is much less than those of the previous design approaches.

Genetics and evidence for balancing selection of a sex-linked colour polymorphism in a songbird.

Colour polymorphisms play a key role in sexual selection and speciation, yet the mechanisms that generate and maintain them are not fully understood. Here, we use genomic and transcriptomic tools to identify the precise genetic architecture and evolutionary history of a sex-linked colour polymorphism in the Gouldian finch Erythrura gouldiae that is also accompanied by remarkable differences in behaviour and physiology. We find that differences in colour are associated with an ~72-kbp region of the Z chromosome in a putative regulatory region for follistatin, an antagonist of the TGF-ß superfamily genes. The region is highly differentiated between morphs, unlike the rest of the genome, yet we find no evidence that an inversion is involved in maintaining the distinct haplotypes. Coalescent simulations confirm that there is elevated nucleotide diversity and an excess of intermediate frequency alleles at this locus. We conclude that this pleiotropic colour polymorphism is most probably maintained by balancing selection.

Comparative Study of Square and Circular Loop Frequency Selective Surfaces for Millimeter-Wave Imaging Diagnostics Systems.

A design method of large-sized square-loop and circular-loop frequency selective surface (FSS) filters for protection of mm-wave imagining receivers is presented. Due to fine cell structure requirements, the performance of the FSS structures at mm-wave frequencies can be significantly affected by fabrication tolerances, especially involved with large-size panel fabrication. Through a comprehensive parametric variation study on the performance of square-loop and circular-loop FSS structures, it is found that the circular-loop FSS structure performs much less sensitively to the fabrication tolerances, thereby producing better and consistent performances with given design values. As a design example, square-loop and circular-loop notch filters resonating at 105 GHz were designed and the performances were evaluated with multiple prototypes. The resonant frequencies of the implemented circular-loop FSS filters deviated by only about 0.5 GHz from the accurate designed value, which can be easily adjusted in the design process. The implemented square-loop and circular loop FSS filters provided low-loss in the pass-band and high rejection of 23 dB at the resonant frequency with good oblique angle performance.

A practical double-sided frequency selective surface for millimeter-wave applications.

Analysis, design, and implementation of a practical, high-rejection frequency selective surface (FSS) are presented in this paper. An equivalent circuit model is introduced for predicting the frequency response of the FSS. The FSS consists of periodic square loop structures fabricated on both sides of the thin dielectric substrate by using the low-cost chemical etching technique. The proposed FSS possesses band-stop characteristics and is implemented to suppress the 170 GHz signal with attenuation of more than 45 dB with insensitivity to an angle of incident plane wave over 20°. Good agreement is observed among calculated, simulated, and measured results. The proposed FSS filter can be used in various millimeter-wave applications such as the protection of imaging diagnostic systems from high spurious input power.

A sex-linked supergene controls sperm morphology and swimming speed in a songbird.

Sperm competition is an important selective force in many organisms. As a result, sperm have evolved to be among the most diverse cells in the animal kingdom. However, the relationship between sperm morphology, sperm motility and fertilization success is only partially understood. The extent to which between-male variation is heritable is largely unknown, and remarkably few studies have investigated the genetic architecture of sperm traits, especially sperm morphology. Here we use high-density genotyping and gene expression profiling to explore the considerable sperm trait variation that exists in the zebra finch Taeniopygia guttata. We show that nearly all of the genetic variation in sperm morphology is caused by an inversion polymorphism on the Z chromosome acting as a 'supergene'. These results provide a striking example of two evolutionary genetic predictions. First, that in species where females are the heterogametic sex, genetic variation affecting sexually dimorphic traits will accumulate on the Z chromosome. Second, recombination suppression at the inversion allows beneficial dominant alleles to become fixed on whichever haplotype they first arise, without being exchanged onto other haplotypes. Finally, we show that the inversion polymorphism will be stably maintained by heterozygote advantage, because heterozygous males have the fastest and most successful sperm.

Design of a 75-140 GHz high-pass printed circuit board dichroic filter.

A new high-performing PCB (Printed Circuit Board) dichroic filter, which can be used for the KSTAR (Korea Superconducting Tokamak Advanced Research) electron cyclotron emission imaging system, is proposed. The current dichroic filter consists of a triangular lattice array of circular holes on the 6-mm thick metal plate, while circular hole spacing limitation caused relatively narrow passband (∼20 GHz). On the other hand, the proposed PCB dichroic filter utilizes the inexpensive commercial PCB fabrication process with a flexible adjustment of circular hole spacing. Therefore, the proposed PCB dichroic filter provides significantly wider passband (∼60 GHz with 0.84 dB insertion loss) with much reduced weight and expense. Also, it is shown that a steep skirt property can be obtained with the thick PCB filter substrate. The design process, fabrication, and measurement results of the new PCB dichroic filter are described.

Red Carotenoid Coloration in the Zebra Finch Is Controlled by a Cytochrome P450 Gene Cluster.

Bright-red colors in vertebrates are commonly involved in sexual, social, and interspecific signaling [1-8] and are largely produced by ketocarotenoid pigments. In land birds, ketocarotenoids such as astaxanthin are usually metabolically derived via ketolation of dietary yellow carotenoids [9, 10]. However, the molecular basis of this gene-environment mechanism has remained obscure. Here we use the yellowbeak mutation in the zebra finch (Taeniopygia guttata) to investigate the genetic basis of red coloration. Wild-type ketocarotenoids were absent in the beak and tarsus of yellowbeak birds. The yellowbeak mutation mapped to chromosome 8, close to a cluster of cytochrome P450 loci (CYP2J2-like) that are candidates for carotenoid ketolases. The wild-type zebra finch genome was found to have three intact genes in this cluster: CYP2J19A, CYP2J19B, and CYP2J40. In yellowbeak, there are multiple mutations: loss of a complete CYP2J19 gene, a modified remaining CYP2J19 gene (CYP2J19(yb)), and a non-synonymous SNP in CYP2J40. In wild-type birds, CYP2J19 loci are expressed in ketocarotenoid-containing tissues: CYP2J19A only in the retina and CYP2J19B in the beak and tarsus and to a variable extent in the retina. In contrast, expression of CYP2J19(yb) is barely detectable in the beak of yellowbeak birds. CYP2J40 has broad tissue expression and shows no differences between wild-type and yellowbeak. Our results indicate that CYP2J19 genes are strong candidates for the carotenoid ketolase and imply that ketolation occurs in the integument in zebra finches. Since cytochrome P450 enzymes include key detoxification enzymes, our results raise the intriguing possibility that red coloration may be an honest signal of detoxification ability.

Collateral ligament injury in the displaced radial head and neck fracture: correlation with fracture morphology and management strategy to the torn ulnar collateral ligament.

BACKGROUND: The purpose of our study was to correlate the morphology of displaced radial head and neck (DRHN) fractures with associated ligament injuries and evaluate the outcomes of management of the torn ulnar collateral ligament (UCL). METHODS: Twenty-nine surgically treated patients presenting with a DRHN fracture were classified using the Charalambous classification by 3-dimensional computed tomography. Accordingly, the collateral ligament and overlying muscle injuries and bony contusions were investigated with magnetic resonance imaging. The valgus stress test was performed intraoperatively on 20 patients with magnetic resonance-confirmed complete UCL rupture. If there was no firm end point, the UCL was repaired (group B). The others were treated conservatively (group A). The Minnesota Elbow Performance Score and Disabilities of the Arm, Shoulder and Hand scores were used to measure patient outcome. RESULTS: There was a trend toward a higher incidence of complete UCL rupture in Charalambous type 3D and 4D fractures (P = .110) and complete lateral UCL rupture in Charalambous type 1D and 2D fractures (P = .126), although this was not statistically significant. Rupture of the overlying muscles was more common in group B than in group A (P < .05). Functional outcome between the 2 groups was not significantly different. CONCLUSIONS: DRHN fracture is always a complex fracture accompanied by collateral ligament injuries. Type 3D and 4D tended to have a higher association with UCL rupture compared with type 1D and 2D, types commonly associated with lateral UCL rupture. The magnetic resonance imaging-confirmed torn UCL could be managed conservatively if there was a firm end point on valgus stress test.

Is posterior synovial plica excision necessary for refractory lateral epicondylitis of the elbow?

BACKGROUND: Arthroscopic treatments for lateral epicondylitis including débridement of the extensor carpi radialis brevis (ECRB) origin (Baker technique) or resection of the radiocapitellar synovial plica reportedly improve symptoms. However the etiology of the disease and the role of the plica remain unclear. QUESTIONS/PURPOSES: We asked if posterior radiocapitellar synovial plica excision made any additional improvement in pain or function after arthroscopic ECRB release. METHODS: We retrospectively reviewed 38 patients who had arthroscopic treatment for refractory lateral epicondylitis between November 2003 and October 2009. Twenty patients (Group A) underwent the Baker technique and 18 patients (Group B) underwent a combination of the Baker technique and posterior synovial plica excision. The minimum followup was 36 months (mean, 46 months; range, 36-72 months) for Group A and 25 months (mean, 30 months; range, 25-36 months) for Group B. Postoperatively we obtained VAS pain and DASH scores for each group. RESULTS: Two years postoperatively, we found no differences in the VAS pain score or DASH: the mean VAS pain scores were 0.3 points in Group A and 0.4 points in Group B, and the DASH scores were 5.1 points and 6.1 points respectively. CONCLUSIONS: The addition of débridement of the posterior synovial fold did not appear to enhance either pain relief or function compared with the classic Baker technique without decortication.

Estimating divergence dates and substitution rates in the Drosophila phylogeny.

An absolute timescale for evolution is essential if we are to associate evolutionary phenomena, such as adaptation or speciation, with potential causes, such as geological activity or climatic change. Timescales in most phylogenetic studies use geologically dated fossils or phylogeographic events as calibration points, but more recently, it has also become possible to use experimentally derived estimates of the mutation rate as a proxy for substitution rates. The large radiation of drosophilid taxa endemic to the Hawaiian islands has provided multiple calibration points for the Drosophila phylogeny, thanks to the "conveyor belt" process by which this archipelago forms and is colonized by species. However, published date estimates for key nodes in the Drosophila phylogeny vary widely, and many are based on simplistic models of colonization and coalescence or on estimates of island age that are not current. In this study, we use new sequence data from seven species of Hawaiian Drosophila to examine a range of explicit coalescent models and estimate substitution rates. We use these rates, along with a published experimentally determined mutation rate, to date key events in drosophilid evolution. Surprisingly, our estimate for the date for the most recent common ancestor of the genus Drosophila based on mutation rate (25-40 Ma) is closer to being compatible with independent fossil-derived dates (20-50 Ma) than are most of the Hawaiian-calibration models and also has smaller uncertainty. We find that Hawaiian-calibrated dates are extremely sensitive to model choice and give rise to point estimates that range between 26 and 192 Ma, depending on the details of the model. Potential problems with the Hawaiian calibration may arise from systematic variation in the molecular clock due to the long generation time of Hawaiian Drosophila compared with other Drosophila and/or uncertainty in linking island formation dates with colonization dates. As either source of error will bias estimates of divergence time, we suggest mutation rate estimates be used until better models are available.

Minimal epicondylectomy improves neurologic deficits in moderate to severe cubital tunnel syndrome.

BACKGROUND: Previous studies of minimal medial epicondylectomy for cubital tunnel syndrome included patients with mild disease, making it difficult to determine how much this procedure improved sensory and motor impairments in patients with moderate to severe disease. QUESTIONS/PURPOSES: We asked if minimal epicondylectomy improved sensory and motor impairments in patients with moderate to severe cubital tunnel syndrome. METHODS: We retrospectively reviewed 25 patients treated with minimal medial epicondylectomy for advanced cubital tunnel syndrome involving motor weakness between January 2003 and February 2009. Preoperatively, five patients had Medical Research Council (MRC) Grade 4 motor strength without atrophy (McGowan Grade IIA), nine had MRC Grade 3 motor strength with detectable atrophy (McGowan Grade IIB), and 11 had MRC Grade 3 or less motor strength with severe atrophy (McGowan Grade III). Postoperatively we obtained DASH scores and evaluated improvement of sensory impairment and motor impairment: excellent with minimal sensory deficit and motor deficit, good with mild deficits, fair with improved but persistent deficit(s), and poor with no improvement. The minimum followup was 13 months (mean, 46 months; range, 13-86 months). RESULTS: The mean DASH score was 14 points (range, 2-47 points). Of the 25 patients, sensory improvement and motor improvement were excellent in 16 patients, good in five, fair in two, and poor in two. Twenty-three of the 25 patients improved at least one McGowan grade. There were no complications, such as medial elbow instability. CONCLUSIONS: Minimal medial epicondylectomy can improve sensory and motor impairments for patients with moderate to severe cubital tunnel syndrome. LEVEL OF EVIDENCE: Level IV, therapeutic study. See the guidelines for authors for a complete description of levels of evidence.