Randomized, Prospective Study Comparing Ulnar Neurolysis In Situ with Submuscular Transposition

Biggs, Michael T.; Curtis, J.

doi:10.1227/01.neu.0000194847.04143.a1

Cited by 188 publications

(107 citation statements)

References 35 publications

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“…A number of studies have been made through the years focusing on outcome after surgical intervention of UNE, where different types of surgical treatments have been compared [16][17][18], but few have focused on and evaluated potential predictors of surgical outcome.…”

Section: Discussionmentioning

confidence: 99%

“…a simple release of structures affecting the ulnar nerve (e.g. Osbourne´s ligament and the arcade at the two heads of flexor carpi ulnaris muscle, over a limited distance) [15] is equal to that of both subcutaneous and submuscular transposition [16][17][18], but with a lower risk of postoperative complications [16,17]. The less invasive, and surgically easier, simple decompression is by some therefore considered as the gold standard when treating the majority of primary UNE cases surgically.…”

Section: Introductionmentioning

confidence: 99%

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Outcome and predictors in simple decompression of ulnar nerve entrapment at the elbow

Anker¹,

Zimmerman²,

Andersson³

et al. 2018

Hand Microsurg

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Objectives:Simple decompression is an accepted surgical treatment of ulnar nerve entrapment at the elbow (UNE). Our purpose was to evaluate the outcome and potential predictors for the outcome after simple decompression in UNE. Methods: All surgically treated UNE cases (from 2004-2008) at our department were studied retrospectively. Out of 285 primary surgeries, 242 primary simple ulnar nerve decompressions were included. Medical records, including electrophysiologic protocols, were reviewed and postoperative outcome was graded: 1) cured/improved and 2) unchanged/worsened symptoms, based on surgeon-evaluated outcome. Results: Of the 242 simple decompressions (122 males and 120 females; median age 50.5 years), 101 cases were students, retired, un-employed, or on a long-term sick-leave and 112 had manual, blue-collar type of work. 189 cases were cured or improved, while 53 cases had no change in, or even worsened, symptoms. Gender, presence of smoking, or associated diseases did not affect outcome, while a tendency was observed for higher age, a manual occupation and constant symptoms. Out of 196 cases electrophysiologically examined, 155 cases showed signs of ulnar nerve affection (56 reduced conduction velocity; 19 conduction block; 80 axonal degeneration; latter two groups significantly worse outcome). Conclusion: Patients with a preoperatively electrophysiologically diagnosed nerve conduction block or axonal degeneration have higher risk of not being cured or improved after simple decompression in UNE. Older patients, those with a manual profession, and constant symptoms of UNE tend to be less improved after surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Outcome and predictors in simple decompression of ulnar nerve entrapment at the elbow

Anker¹,

Zimmerman²,

Andersson³

et al. 2018

Hand Microsurg

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“…Most comparative studies demonstrate similar results and no particular technique has been demonstrated to be associated with statistical differences among the results obtained (14)(15)(16)(17)(18)(19)(20)(21)(22)(23) .…”

Section: Discussionmentioning

confidence: 90%

Tratamento da síndrome do túnel cubital pela técnica de transposição anterior subcutânea: será este método seguro e eficaz?

Lima¹,

Correia²,

Martins³

et al. 2012

Rev. bras. ortop.

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after surgery. According to the modified Bishop score, 21 patients (58.3%) had excellent results, seven (19.4%) good, six (16.7%) satisfactory and two (5.55%) poor. The satisfaction rate was 86% and 72% of the patients recovered their daily activities without limitations. Conclusion: The severity of neuropathy and preoperative duration of symptoms, but not age, had a negative influence on the outcome. The subcutaneous anterior transposition of the cubital nerve is safe and effective for treating CTS of different degrees of severity. Given the major prognostic factors identified, surgical treatment should be advised as soon as axonal loss has become clinically evident.

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“…The recommendation to favor simple decompression (SD) despite lack of statistical evidence is debatable. All randomized clinical trials show no clinical difference when comparing simple decompression versus transposition [2,3,10,22]. 2.…”

Section: Discussionmentioning

confidence: 99%

Surgical Options for Ulnar Nerve Entrapment: An Example of Individualized Decision Analysis

Gasco

2009

Hand (New York, N,Y.)

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The decision-making process in the diagnosis and treatment of an ulnar nerve entrapment (UNE) at the elbow is presented from the viewpoint of the patient and from that of a physician who in this case, were the same individual. The problems of diagnosis and the selection of the appropriate therapy-conservative or surgical and the choice of a particular surgical approach are discussed in the light of recent evidence-based medicine (EMB) literature.

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Randomized, Prospective Study Comparing Ulnar Neurolysis In Situ with Submuscular Transposition

Cited by 188 publications

References 35 publications

Outcome and predictors in simple decompression of ulnar nerve entrapment at the elbow

Outcome and predictors in simple decompression of ulnar nerve entrapment at the elbow

Tratamento da síndrome do túnel cubital pela técnica de transposição anterior subcutânea: será este método seguro e eficaz?

Surgical Options for Ulnar Nerve Entrapment: An Example of Individualized Decision Analysis

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