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Factors Influencing Outcomes after Ulnar Nerve Stability-Based Surgery for Cubital Tunnel Syndrome: A Prospective Cohort Study

Authors
 Ho Jung Kang  ;  Won Taek Oh  ;  Il Hyun Koh  ;  Sungmin Kim  ;  Yun Rak Choi 
Citation
 YONSEI MEDICAL JOURNAL, Vol.57(2) : 455-460, 2016 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2016
MeSH
Adult ; Cubital Tunnel Syndrome/diagnosis* ; Cubital Tunnel Syndrome/physiopathology ; Cubital Tunnel Syndrome/surgery* ; Decompression, Surgical/methods* ; Female ; Follow-Up Studies ; Hand/surgery ; Hand Strength ; Humans ; Male ; Middle Aged ; Neurosurgical Procedures/methods* ; Prospective Studies ; Recovery of Function ; Surveys and Questionnaires ; Treatment Outcome ; Ulnar Nerve/physiopathology ; Ulnar Nerve/surgery* ; Young Adult
Keywords
Cubital tunnel syndrome ; anterior transposition ; prognostic factor ; simple decompression ; ulnar nerve stability-based surgery
Abstract
PURPOSE: Simple decompression of the ulnar nerve has outcomes similar to anterior transposition for cubital tunnel syndrome; however, there is no consensus on the proper technique for patients with an unstable ulnar nerve. We hypothesized that 1) simple decompression or anterior ulnar nerve transposition, depending on nerve stability, would be effective for cubital tunnel syndrome and that 2) there would be determining factors of the clinical outcome at two years. MATERIALS AND METHODS: Forty-one patients with cubital tunnel syndrome underwent simple decompression (n=30) or anterior transposition (n=11) according to an assessment of intra-operative ulnar nerve stability. Clinical outcome was assessed using grip and pinch strength, two-point discrimination, the mean of the disabilities of arm, shoulder, and hand (DASH) survey, and the modified Bishop Scale. RESULTS: Preoperatively, two patients were rated as mild, another 20 as moderate, and the remaining 19 as severe according to the Dellon Scale. At 2 years after operation, mean grip/pinch strength increased significantly from 19.4/3.2 kg to 31.1/4.1 kg, respectively. Two-point discrimination improved from 6.0 mm to 3.2 mm. The DASH score improved from 31.0 to 14.5. All but one patient scored good or excellent according to the modified Bishop Scale. Correlations were found between the DASH score at two years and age, pre-operative grip strength, and two-point discrimination. CONCLUSION: An ulnar nerve stability-based approach to surgery selection for cubital tunnel syndrome was effective based on 2-year follow-up data. Older age, worse preoperative grip strength, and worse two-point discrimination were associated with worse outcomes at 2 years.
Files in This Item:
T201600858.pdf Download
DOI
10.3349/ymj.2016.57.2.455
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Ho Jung(강호정) ORCID logo https://orcid.org/0000-0003-0273-1264
Koh, Il Hyun(고일현) ORCID logo https://orcid.org/0000-0001-9823-8516
Kim, Sung Min(김성민)
Oh, Won Taek(오원택) ORCID logo https://orcid.org/0000-0003-1815-0851
Choi, Yun Rak(최윤락)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146545
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