Trend of Recovery after Simple Decompression for Treatment of Ulnar Neuropathy at the Elbow

Abstract

Background Although numerous studies have investigated long-term outcomes after surgical treatment of ulnar neuropathy at the elbow with simple decompression, no study has evaluated the trend of postoperative recovery. The authors assessed timing of recovery after simple decompression for ulnar neuropathy at the elbow. Methods The five-center Surgery of the Ulnar Nerve Study Group prospectively recruited 58 consecutive subjects with ulnar neuropathy at the elbow and treated them with simple decompression. Patients were evaluated preoperatively and at 6 weeks, 3 months, 6 months, and 1 year postoperatively. Patient-rated outcomes questionnaires included the Michigan Hand Questionnaire; the Disabilities of the Arm, Shoulder and Hand questionnaire; and the Carpal Tunnel Questionnaire. Functional tests used were grip strength, key pinch strength, two-point discrimination, and Semmes-Weinstein monofilament testing. Postoperative improvement was assessed at each time point to establish the trend of recovery in reaching a plateau. Results Significant patient-reported symptomatic and functional recovery occurred over the first 6 weeks postoperatively as represented by improvements in questionnaire scores. Symptomatic recovery occurred earlier than functional recovery as measured by sensory and strength testing and the work domain of the Michigan Hand Questionnaire. Improvement in patient-reported outcomes continued and reached a plateau at 3 months, whereas measured strength and sensory recovery continued over 12 months. Conclusion The greatest clinical improvement after simple decompression for ulnar neuropathy at the elbow, according to questionnaire scores, occurs in the first 6 weeks postoperatively and reaches a plateau by 3 months.

Outcome of simple decompression of the compressed ulnar nerve at the elbow – influence of smoking, gender, and electrophysiological findings

“…It should be noted that the excluded patients, who only responded preoperatively, did not differ in character from the included patients [21]. Another limitation is that we did not follow the patients with different clinical tests or with electrophysiological examinations, which has been done in a similar study [15,19]. The recovery, measured by functional variables, is slower than is seen in the patient-reported questionnaires [15].…”

“…Another limitation is that we did not follow the patients with different clinical tests or with electrophysiological examinations, which has been done in a similar study [15,19]. The recovery, measured by functional variables, is slower than is seen in the patient-reported questionnaires [15]. Thus, it may be sufficient with information obtained from the questionnaires.…”

“…QuickDASH is a questionnaire, which the patients fill in before and at one year after surgery. At that time it is considered that the healing process is finished and all temporary side effects has even out [6,15]. QuickDASH consists of 11 items in which the patients rank their problems on a scale from 1 to 5.…”

Surgical Treatment of Cubital Tunnel Syndrome: Trends and the Influence of Patient and Surgeon Characteristics

“…There is disagreement in the literature regarding the most commonly used method of treatment for cubital tunnel syndrome (5, 14-16). Furthermore, recent literature has shown no difference in treatment effectiveness between in-situ decompression and transposition, although fewer complications have been reported after in-situ decompression (17-30). These findings underscore the challenges associated with selecting the most appropriate procedure for cubital tunnel syndrome treatment.…”

Diagnosis and Treatment of Work-Related Ulnar Neuropathy at the Elbow

“…Surgery should include exploration of the ulnar nerve throughout its course around the elbow and release of all compressive structures. 22,23 Complete release may require nerve decompression at multiple sites and may also require Z-lengthening of the flexor pronator origin, if elevated to allow for anterior submuscular transposition. A Cochrane review analyzed the available literature regarding the effectiveness and safety of conservative and surgical treatments in UNE.…”