Reporting Outcomes and Outcome Measures in Cubital Tunnel Syndrome: A Systematic Review

Gallo, Lucas; Gallo, Matteo; Murphy, Jessica; Waltho, Daniel; Baxter, Charmaine; Karpinski, Marta; Mowakket, Sadek; Copeland, Andrea; Thoma, Achilleas

doi:10.1016/j.jhsa.2020.04.001

Cited by 17 publications

(22 citation statements)

References 114 publications

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“…The primary limitation of this study is the small number of patients with DM, which raises the possibility of skewed data, and precludes more sophisticated statistical analysis of predictors of function following surgery. It should be noted, however, that the overall sample size compares favourably with the majority of previous reports (Gallo et al., 2020), and that our study is strengthened by a high follow-up rate with a comparatively long follow-up period (Burahee et al., 2022), although a recent study has suggested that loss to follow-up may not necessarily affect the outcomes of studies using PROMs (Stirling et al., 2022a). A further limitation is the absence of data relating to glycaemic control, although this limitation is shared with multiple previous studies investigating the effect of DM on other conditions affecting the hand (Eckerdal et al., 2014; Jenkins et al., 2012; Stirling et al., 2020).…”

Section: Discussionsupporting

confidence: 63%

The effect of diabetes mellitus on the outcome of surgery for cubital tunnel syndrome

Stirling

Harrison

McEachan

2022

J Hand Surg Eur Vol

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The aims of this study were to investigate the effect of diabetes mellitus (DM) on patient-reported outcome measures (PROMs) and satisfaction after surgery for cubital tunnel syndrome (CuTS). Pre- and 1-year postoperative QuickDASH, normal hand, and satisfaction scores were prospectively collected from 107 patients over a 6-year period. Patients without DM reported a significant QuickDASH improvement after surgery (preoperative 34.1 versus postoperative 20.5; p < 0.001), but patients with DM did not (preoperative 46.5 versus postoperative 43.2; p = 0.554). Postoperative QuickDASH (43.2 versus 20.5) and normal hand (65 versus 80) scores were significantly worse in patients with DM. Satisfaction rates were excellent in both groups (88% versus 82%; p = 0.480). Our study showed that surgery for CuTS did not lead to an improvement in QuickDASH score in patients with DM and consequently patients with DM reported worse postoperative PROMs compared with those without. However, lack of improvement in PROMs does not affect patient satisfaction. Level of evidence: IV

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Section: Discussionsupporting

confidence: 63%

The effect of diabetes mellitus on the outcome of surgery for cubital tunnel syndrome

Stirling

Harrison

McEachan

2022

J Hand Surg Eur Vol

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“…Different outcome measurements were used at varying time points in the included studies. The same issue has been described for primary cubital tunnel syndrome (Gallo et al., 2020). As a result, there were insufficient data for a meta-analysis.…”

Section: Resultsmentioning

confidence: 59%

Challenging the dogma: anterior transposition of the ulnar nerve is indicated in recurrent cubital tunnel syndrome

Ruettermann

2020

J Hand Surg Eur Vol

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The current evidence for treatment of primary idiopathic cubital tunnel syndrome favours an in situ release. However, anterior transposition of the ulnar nerve remains a popular procedure in recurrent cubital tunnel syndrome. For more than 20 years, I have performed an extended in situ release only, and achieved similar or better results than with nerve transposition. In performing a systematic review of the evidence for surgery for recurrent cubital tunnel syndrome, I could only include 16 out of 296 studies regarding treatment of recurrent cases of cubital tunnel syndrome. A meta-analysis was not possible, due to selection bias and disparity of outcome measurements of the studies. However, I could not find robust evidence that supports the need of an anterior transposition of the ulnar nerve in recurrent cubital tunnel syndrome over an in situ decompression. My own experience of an extended in situ release with complete neurolysis with reasonable outcomes, in combination with the lack of literature support of anterior transposition in recurrent cases, have led me to the consideration that this dogma should be revised.

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“…A review of reported outcome measures following CuTS identified 101 studies which used 45 unique outcomes and 31 postoperative outcome measures. 22 The Patient-Rated Ulna Nerve Evaluation (PRUNE) score was the only validated diagnosis-specific tool, but was only reported in 3% of included studies. This results in meta-analysis being of limited benefit due to the heterogeneity of reported data.…”

Section: Discussionmentioning

confidence: 99%

The management of failed cubital tunnel decompression

2021

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Cubital tunnel decompression is a commonly performed operation with a much higher failure rate than carpal tunnel release. Failed cubital tunnel release generally occurs due to an inadequate decompression in the primary procedure, new symptoms due to an iatrogenic cause, or development of new areas of nerve irritation. Our preferred technique for failed release is revision circumferential neurolysis with medial epicondylectomy, as this eliminates strain, removes the risk of subluxation, and avoids the creation of secondary compression points. Adjuvant techniques including supercharging end-to-side nerve transfer and nerve wrapping show promise in improving the results of revision surgery. Limited quality research exists in this subject, compounded by the lack of consensus on diagnostic criteria, classification, and outcome assessment. Cite this article: EFORT Open Rev 2021;6:735-742. DOI: 10.1302/2058-5241.6.200135

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Reporting Outcomes and Outcome Measures in Cubital Tunnel Syndrome: A Systematic Review

Cited by 17 publications

References 114 publications

The effect of diabetes mellitus on the outcome of surgery for cubital tunnel syndrome

The effect of diabetes mellitus on the outcome of surgery for cubital tunnel syndrome

Challenging the dogma: anterior transposition of the ulnar nerve is indicated in recurrent cubital tunnel syndrome

The management of failed cubital tunnel decompression

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