Limits...
Ulnar nerve stability-based surgery for cubital tunnel syndrome via a small incision: a comparison with classic anterior nerve transposition.

Kang HJ, Koh IH, Chun YM, Oh WT, Chung KH, Choi YR - J Orthop Surg Res (2015)

Bottom Line: Clinical outcome was assessed using grip and pinch strength, two-point discrimination, the mean of the disabilities of arm, shoulder, and hand (DASH) survey, and the modified Bishop scale.At the final follow-up, all outcome measures improved significantly in both groups and there were no significant differences between the two groups.However, there were fewer operation-related complications in group A (one revision surgery) than in group B (one superficial infection, two painful scars, and five cases of numbness at the medial elbow).

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Yonseiro 50-1, Seodaemun-gu, Seoul, 120-752, Republic of Korea.

ABSTRACT

Objective: The purpose of this study was to compare the clinical outcomes of ulnar nerve stability-based surgery via a small incision with those of classic anterior transposition of the ulnar nerve for cubital tunnel syndrome.

Methods: From March 2008 to December 2013, 107 patients with cubital tunnel syndrome underwent simple decompression or anterior transposition via a small incision, according to an ulnar nerve stability-based decision based on an assessment of intraoperative ulnar nerve stability (group A, n = 51), or anterior transposition via a classic incision (group B, n = 56). Clinical outcome was assessed using grip and pinch strength, two-point discrimination, the mean of the disabilities of arm, shoulder, and hand (DASH) survey, and the modified Bishop scale.

Results: At the final follow-up, all outcome measures improved significantly in both groups and there were no significant differences between the two groups. However, there were fewer operation-related complications in group A (one revision surgery) than in group B (one superficial infection, two painful scars, and five cases of numbness at the medial elbow).

Conclusions: Outcomes after the ulnar nerve stability-based approach and anterior transposition were similar, although more patients experienced operation-related complications after anterior transposition via a classic incision. Making an ulnar nerve stability-based decision to perform either simple decompression or anterior transposition via a small incision seems to be a better strategy for patients with cubital tunnel syndrome.

No MeSH data available.


Related in: MedlinePlus

The CONSORT diagram of enrollment and analysis in this study
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4526197&req=5

Fig1: The CONSORT diagram of enrollment and analysis in this study

Mentions: Based on these criteria, four patients with electrodiagnostically silent cubital tunnel syndrome, nine patients with cubitus valgus, 14 patients with elbow osteoarthritis, seven patients requiring revision surgery, 13 patients with one of the associated diseases mentioned above, and five worker’s compensation patients were excluded. Four patients were lost to follow-up. Consequently, 56 patients were excluded, and 107 patients were available for the study (Fig. 1). Among our study population, 12 patients had bilateral cubital tunnel syndrome. In these patients, we analyzed only the dominant extremity. We then had 51 patients who underwent an ulnar nerve stability-based approach involving either simple decompression (n = 37) or anterior transposition (n = 14) via a small incision (group A) and 56 patients who underwent anterior subcutaneous transposition of the ulnar nerve via a classic incision (group B). There was a distinct time period for each type of operation. Briefly, we performed anterior transposition of the ulnar nerve via a classic incision earlier in the duration of the study and changed the technique to an ulnar nerve stability-based approach via a small incision in June 2010. Group A included 32 men and 19 women with a mean age of 38.3 ± 15.0 years (range, 20–68 years) at the time of surgery. The duration of symptoms to surgery was 24.1 ± 31.2 months (range, 3–120 months). The mean follow-up period after the operation was 30.2 ± 10.8 months (range, 12–48 months). Group B included 37 men and 19 women with a mean age of 35.7 ± 16.7 years (range, 19–66 years) at the time of surgery. The duration of symptoms to surgery was 23.0 ± 26.8 months (range, 5–96 months). The mean follow-up period after the operation was 34.1 ± 13.2 months (range, 12–60 months; Table 1). Our institutional review board approved the study and waived the requirement for informed consent.Fig. 1


Ulnar nerve stability-based surgery for cubital tunnel syndrome via a small incision: a comparison with classic anterior nerve transposition.

Kang HJ, Koh IH, Chun YM, Oh WT, Chung KH, Choi YR - J Orthop Surg Res (2015)

The CONSORT diagram of enrollment and analysis in this study
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4526197&req=5

Fig1: The CONSORT diagram of enrollment and analysis in this study
Mentions: Based on these criteria, four patients with electrodiagnostically silent cubital tunnel syndrome, nine patients with cubitus valgus, 14 patients with elbow osteoarthritis, seven patients requiring revision surgery, 13 patients with one of the associated diseases mentioned above, and five worker’s compensation patients were excluded. Four patients were lost to follow-up. Consequently, 56 patients were excluded, and 107 patients were available for the study (Fig. 1). Among our study population, 12 patients had bilateral cubital tunnel syndrome. In these patients, we analyzed only the dominant extremity. We then had 51 patients who underwent an ulnar nerve stability-based approach involving either simple decompression (n = 37) or anterior transposition (n = 14) via a small incision (group A) and 56 patients who underwent anterior subcutaneous transposition of the ulnar nerve via a classic incision (group B). There was a distinct time period for each type of operation. Briefly, we performed anterior transposition of the ulnar nerve via a classic incision earlier in the duration of the study and changed the technique to an ulnar nerve stability-based approach via a small incision in June 2010. Group A included 32 men and 19 women with a mean age of 38.3 ± 15.0 years (range, 20–68 years) at the time of surgery. The duration of symptoms to surgery was 24.1 ± 31.2 months (range, 3–120 months). The mean follow-up period after the operation was 30.2 ± 10.8 months (range, 12–48 months). Group B included 37 men and 19 women with a mean age of 35.7 ± 16.7 years (range, 19–66 years) at the time of surgery. The duration of symptoms to surgery was 23.0 ± 26.8 months (range, 5–96 months). The mean follow-up period after the operation was 34.1 ± 13.2 months (range, 12–60 months; Table 1). Our institutional review board approved the study and waived the requirement for informed consent.Fig. 1

Bottom Line: Clinical outcome was assessed using grip and pinch strength, two-point discrimination, the mean of the disabilities of arm, shoulder, and hand (DASH) survey, and the modified Bishop scale.At the final follow-up, all outcome measures improved significantly in both groups and there were no significant differences between the two groups.However, there were fewer operation-related complications in group A (one revision surgery) than in group B (one superficial infection, two painful scars, and five cases of numbness at the medial elbow).

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Yonseiro 50-1, Seodaemun-gu, Seoul, 120-752, Republic of Korea.

ABSTRACT

Objective: The purpose of this study was to compare the clinical outcomes of ulnar nerve stability-based surgery via a small incision with those of classic anterior transposition of the ulnar nerve for cubital tunnel syndrome.

Methods: From March 2008 to December 2013, 107 patients with cubital tunnel syndrome underwent simple decompression or anterior transposition via a small incision, according to an ulnar nerve stability-based decision based on an assessment of intraoperative ulnar nerve stability (group A, n = 51), or anterior transposition via a classic incision (group B, n = 56). Clinical outcome was assessed using grip and pinch strength, two-point discrimination, the mean of the disabilities of arm, shoulder, and hand (DASH) survey, and the modified Bishop scale.

Results: At the final follow-up, all outcome measures improved significantly in both groups and there were no significant differences between the two groups. However, there were fewer operation-related complications in group A (one revision surgery) than in group B (one superficial infection, two painful scars, and five cases of numbness at the medial elbow).

Conclusions: Outcomes after the ulnar nerve stability-based approach and anterior transposition were similar, although more patients experienced operation-related complications after anterior transposition via a classic incision. Making an ulnar nerve stability-based decision to perform either simple decompression or anterior transposition via a small incision seems to be a better strategy for patients with cubital tunnel syndrome.

No MeSH data available.


Related in: MedlinePlus