Prospective Cohort Study of Symptom Resolution outside of the Ulnar Nerve Distribution following Cubital Tunnel Release

Abstract

Background Resolution of symptoms including pain, numbness, and tingling outside of the median nerve distribution has been shown to occur following carpal tunnel release. We hypothesized that a similar effect would be found after release of the ulnar nerve at the elbow. Methods Twenty patients with isolated cubital tunnel syndrome were prospectively enrolled. The upper extremity was divided into six zones, and the location of pain, numbness, tingling, or strange sensations was recorded pre-operatively. Two-point discrimination, Semmes-Weinstein monofilament testing, and validated questionnaires were collected. The same data were collected at 6-week follow-up. Paired t tests or nonparametric Wilcoxon Signed-Rank tests were used where appropriate to examine for significant (p≤0.05) changes between pre-and post-operative scores. Results Probability of resolution was greater outside of the ulnar nerve distribution than within at early follow-up. There was a decrease in pain, numbness, and tingling symptoms both within and outside the ulnar distribution after cubital tunnel release. There was a decrease in pain as measured by several validated questionnaires. Conclusion This study documents resolution of symptoms in an extra-ulnar distribution after cubital tunnel release. Improvement in pain and function after cubital tunnel release may be associated with an improvement in symptoms both within and outside the ulnar nerve distribution. Future studies could be directed at correlating pre-operative disease severity with probability of extra-territorial symptom resolution using a larger sample population.

The Prevalence of Cubital Tunnel Syndrome: A Cross-Sectional Study in a U.S. Metropolitan Cohort

“…Furthermore, studies have indicated resolution of symptoms in the ulnar nerve distribution following carpal tunnel release 14,34 . Conversely, evidence has also supported the observation that median nerve symptoms resolve following a surgical procedure for cubital tunnel syndrome confirmed by nerve conduction study and electromyography 35 . These studies serve to highlight the myriad difficulties that impede the establishment of robust, valid definitions for carpal tunnel syndrome and cubital tunnel syndrome.…”