Purpose
Cubital tunnel syndrome is the second most common compression neuropathy in the upper extremity. A variety of procedures are used for treatment of cubital tunnel syndrome. There is a lack of consensus regarding the most appropriate procedure owing to similar rates of operative success and strong proponents for each technique. Our aim was to examine trends in and determinants of the use of different procedures for treatment of cubital tunnel syndrome.
Methods
We performed a retrospective cross-sectional analysis of the Healthcare Cost and Utilization Project Florida State Ambulatory Surgery Database for 2005 to 2012. We selected all patients who underwent in-situ decompression, transposition, or other surgical treatments for cubital tunnel syndrome. We tested trends in the use of these techniques and performed a multivariable analysis to examine associations between patient characteristics and surgeon case volume and the use of different techniques.
Results
Of the 26,164 patients who underwent surgery for cubital tunnel syndrome, 79.7% underwent in-situ decompression, 16.2% underwent transposition, and 4.1% underwent other surgical treatment. Over the study period, there was a statistically significant increase in the use of in-situ release and a decrease in the use of transposition. Females and patients treated by surgeons with a higher cubital tunnel surgery case volume underwent in-situ release at a statistically higher rate than other techniques.
Conclusions
In Florida, surgeon practice reflects the widespread adoption of in-situ release as the primary treatment for cubital tunnel syndrome and these numbers are increasing. Patient demographics and surgeon-level factors influence procedure selection.
Level of Evidence
III, Therapeutic