Muscle Atrophy at Presentation of Cubital Tunnel Syndrome

Abstract

Background: The purpose of this study is to describe the demographics and duration of symptoms of patients with cubital tunnel syndrome who present with muscle atrophy. Methods: We identified 146 patients who presented to the hand surgery clinic at a single institution over a 5-year period with an initial diagnosis of cubital tunnel syndrome based on history and physical examination. Medical records were retrospectively reviewed to determine if there was a difference in demographic data, physical examination findings, and duration of symptoms in patients who presented with muscle atrophy from those with sensory complaints alone. Results: A total of 17/146 (11.6%) of patients presented with muscle atrophy, all of which were men. In all, 17.2% of men presented with atrophy. Age by itself was not a predictor of presentation with atrophy; however, younger patients with atrophy presented with significantly shorter duration of symptoms. Patients under the age of 29 years presenting with muscle atrophy on average had symptoms for 2.4 months compared with 16.2 months of symptoms for those over 55 years of age. Conclusions: Men with cubital tunnel syndrome are more likely to present with muscle atrophy than women. Age is not necessarily a predictor of presentation with atrophy. There is a subset population of younger patients who presents with extremely short duration of symptoms that rapidly develops muscle atrophy.

A Comprehensive Review of Cubital Tunnel Syndrome

“…This study hypothesized that young patients belonging to certain demographic group may experience muscular atrophy quicker than others. 15 The study also reported that gender is a determining factor in prediction of atrophy as a presentation of CuTS. In this study, the age of the patient did not predict presentation with muscular atrophy, although, young patients with muscular atrophy recovered earlier than older patients with muscular atrophy.…”

“…14 According to a retrospective study conducted at a single tertiary center, some of the early signs of CuTS are numbness and tingling of the ring and 5 th finger or hand weakness due to the ulnar nerve compression at the elbow. 15 The weakness is due to muscular atrophy seen in cubital tunnel syndrome. This study hypothesized that young patients belonging to certain demographic group may experience muscular atrophy quicker than others.…”

“…In this study, the age of the patient did not predict presentation with muscular atrophy, although, young patients with muscular atrophy recovered earlier than older patients with muscular atrophy. 15 In a study comparing the presentation of CuTS between older patient and younger patients, Naran et al described that older patients tended to present with motor symptoms of chronic onset. Slow onset prevented early diagnosis in older patients compared to younger patients who primarily presented acutely with sensory symptoms which lead to faster diagnosis.…”

Tardy ulnar nerve palsy following a neglected childhood lateral epicondyle fracture non-union and resultant cubitus valgus deformity

“…Typically, those with ulnar neuropathy tend to complain of generalised hand weakness and loss of dexterity,3 in addition to symptoms of weakness and paraesthesia in the ulnar nerve distribution 3. While an ulnar nerve neuropathy can precipitate visible deformity and muscle atrophy on examination, this is usually witnessed in less than 12% of those with a confirmed ulnar neuropathy,3 with these signs usually only occurring in those with a prolonged duration of symptoms.…”

“…The described case clearly displayed features of deformity traditionally associated with ulnar nerve palsy, with evidence of interosseous muscle wasting and hypothenar eminence flattening easily appreciated on general inspection, particularly when compared with the unaffected limb (figure 1). Given the relative rarity in which these features are encountered,3 appreciation of the demonstrated clinical signs may aid in improved future diagnosis, hence improving management of this potentially debilitating condition.…”