A complete analysis of the surgical treatment for cubital tunnel syndrome: an umbrella review

Bonczar, Michał; Ostrowski, Patryk; Plutecki, Dawid; Dziedzic, Martyna; Depukat, Paweł; Walocha, Jerzy; Koziej, Mateusz

doi:10.1016/j.jse.2022.11.025

Cited by 8 publications

(11 citation statements)

References 24 publications

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“…Interestingly, medial elbow pain can also exist independently from the ulnar nerve entrapment, indicating that medial elbow pain is not a clear diagnostic symptom of ulnar nerve entrapment [ 81 ]. The more extensive surgical procedures, like any type of transposition, are associated with complications, such as paresthesia and elbow pain, as well as a risk for revision surgery [ 2 , 82 , 83 ]. Pain can be reduced by revision surgery, particularly using a submuscular, but sometimes also a subcutaneous, ulnar nerve transposition, for ulnar nerve entrapment, but the application of strict principles in primary surgery for the condition is even more important [ 84 ].…”

Section: Ulnar Nerve Entrapmentmentioning

confidence: 99%

“…There is no consensus on the indication for surgical treatment or the choice of surgical method, including the use of preoperative electrophysiology [ 2 , 23 , 82 , 119 , 120 , 121 , 122 , 123 , 124 ]. There may be several explanations for the lack of consensus, such as the organization of the health care sector, the patient characteristics, the competence of treating surgeon, as well as the local traditions and possible global guidelines.…”

Section: Treatmentmentioning

confidence: 99%

“…In ours and others’ opinions, a simple decompression is the best technique and has a low risk of complications. Direct comparison of various techniques and studies may be problematic since different outcome measurements for evaluation of the surgical procedure have been used [ 2 , 125 , 126 , 127 , 128 ]. Suspected sites of compression are decompressed under loop magnification ( Figure 5 ).…”

Section: Treatmentmentioning

confidence: 99%

“…Nerve entrapment affecting the ulnar nerve—ulnar nerve entrapment—can be challenging to treat. The symptoms that affected patients present, often with a prominent pain component, may be difficult to judge, and even defining a precise diagnosis of ulnar nerve entrapment is demanding due to the heterogeneities of the patient population, sometimes extensive comorbidity, and influencing socioeconomic factors [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 ]. There are speculations that the ulnar nerve and its large, myelinated nerve fibers are more susceptible to diseases and injuries because of the limited “reserve capacity” of nerve fibers [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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The Unpredictable Ulnar Nerve—Ulnar Nerve Entrapment from Anatomical, Pathophysiological, and Biopsychosocial Aspects

Nyman,

Dahlin

2024

Diagnostics

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Peripheral nerves consist of delicate structures, including a rich microvascular system, that protect and nourish axons and associated Schwann cells. Nerves are sensitive to internal and external trauma, such as compression and stretching. Ulnar nerve entrapment, the second most prevalent nerve entrapment disorder after carpal tunnel syndrome, appears frequently at the elbow. Although often idiopathic, known risk factors, including obesity, smoking, diabetes, and vibration exposure, occur. It exists in all adult ages (mean age 40–50 years), but seldom affects individuals in their adolescence or younger. The patient population is heterogeneous with great co-morbidity, including other nerve entrapment disorders. Typical early symptoms are paresthesia and numbness in the ulnar fingers, followed by decreased sensory function and muscle weakness. Pre- and postoperative neuropathic pain is relatively common, independent of other symptom severity, with a risk for serious consequences. A multimodal treatment strategy is necessary. Mild to moderate symptoms are usually treated conservatively, while surgery is an option when conservative treatment fails or in severe cases. The decision to perform surgery might be difficult, and the outcome is unpredictable with the risk of complications. There is no consensus on the choice of surgical method, but simple decompression is relatively effective with a lower complication rate than transposition.

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Section: Ulnar Nerve Entrapmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Unpredictable Ulnar Nerve—Ulnar Nerve Entrapment from Anatomical, Pathophysiological, and Biopsychosocial Aspects

Nyman,

Dahlin

2024

Diagnostics

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“…Several meta-analyses and systematic reviews have tried to determine which surgical technique is associated with the best outcome and lowest risk of complications. The results are often contradictory and accompanied by a variety of recommendations [95][96][97][98][99] .…”

Section: Outcome After Surgery For Unementioning

confidence: 99%

Surgery for ulnar nerve compression at the elbow : Focusing on factors influencing outcome

Giöstad

2023

Linköping University Medical Dissertations

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Ulnar nerve compression at the elbow (UNE) is a common peripheral nerve compression disorder in the upper limb. The literature regarding surgical outcome is inconclusive.This thesis aims to highlight various aspects of real-life settings for patients with UNE and to increase the understanding of underlying factors influencing the outcome of surgery.Patients undergoing surgery for UNE at a tertiary referral hospital were retrospectively evaluated (Linköping cohort; n=202). Comorbidity was extensive.Patients treated with simple decompression (SD) had a lower rate of complications than those with transposition surgery. Emerging neurogenic pain was the most common complication, with a two-fold risk for smokers. Scores from the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire revealed no differences between the surgical groups. Satisfaction with surgery was relatively low (53%), however only 8% stated that they would not go through the same surgical procedure again.Images from magnetic resonance imaging (MRI), performed in conjunction with surgery (Linköping cohort; 62 patients), were re-evaluated by a neuroradiologist.Spinal nerve root pathology contributing to the ulnar nerve (C8-Th1) was rare (1/62 patients), however, nerve root affections at other levels were common (26/62). No relation between cervical pathology and patient-reported outcome was seen.The Linköping cohort was combined with two cohorts from Region Skåne to evaluate time before return to work (RTW) after surgery for UNE (n=635 in total). RTW within 6 weeks was more common among older, SD and non-manual workers.Those who were unemployed were on sick leave longer than the rest of the population.Transposition of the ulnar nerve was the only predictor for prolonged RTW in the regression model. Paper V Experiences of living with chronic pain in conjunction with surgery for ulnar nerve compression at the elbowa qualitative studyAim: To explore experiences and consequences of living with chronic pain in conjunction with surgery for UNE.Methods: Purposeful sampling including patients with experience of chronic pain (lasting >3 months) in conjunction with UNE surgery/surgeries. In-depth interviews were carried out and transcribed. The transcripts were read and re-read and subjected to content analysis independently by two people.Results and conclusions: Chronic pain in conjunction with surgery for UNE affects most aspects of daily life and contributes to a heavy burden for the individual. The results clarify the need for a biopsychosocial approach among healthcare personnel when treating patients with UNE.

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Recurrence of ulnar tunnel syndrome: Long-term clinical and functional results of surgical management using revision neurolysis and subcutaneous anterior transposition

Simon,

Tranier,

Bigorre

et al. 2024

Hand Surgery and Rehabilitation

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A complete analysis of the surgical treatment for cubital tunnel syndrome: an umbrella review

Cited by 8 publications

References 24 publications

The Unpredictable Ulnar Nerve—Ulnar Nerve Entrapment from Anatomical, Pathophysiological, and Biopsychosocial Aspects

The Unpredictable Ulnar Nerve—Ulnar Nerve Entrapment from Anatomical, Pathophysiological, and Biopsychosocial Aspects

Surgery for ulnar nerve compression at the elbow : Focusing on factors influencing outcome

Recurrence of ulnar tunnel syndrome: Long-term clinical and functional results of surgical management using revision neurolysis and subcutaneous anterior transposition

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