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Prospective cohort study of symptom resolution outside of the ulnar nerve distribution following cubital tunnel release

  • Surgery Articles
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HAND

Abstract

Background

Resolution of symptoms including pain, numbness, and tingling outside of the median nerve distribution has been shown to occur following carpal tunnel release. We hypothesized that a similar effect would be found after release of the ulnar nerve at the elbow.

Methods

Twenty patients with isolated cubital tunnel syndrome were prospectively enrolled. The upper extremity was divided into six zones, and the location of pain, numbness, tingling, or strange sensations was recorded pre-operatively. Two-point discrimination, Semmes-Weinstein monofilament testing, and validated questionnaires were collected. The same data were collected at 6-week follow-up. Paired t tests or non-parametric Wilcoxon Signed-Rank tests were used where appropriate to examine for significant (p ≤ 0.05) changes between pre- and post-operative scores.

Results

Probability of resolution was greater outside of the ulnar nerve distribution than within at early follow-up. There was a decrease in pain, numbness, and tingling symptoms both within and outside the ulnar distribution after cubital tunnel release. There was a decrease in pain as measured by several validated questionnaires.

Conclusion

This study documents resolution of symptoms in an extra-ulnar distribution after cubital tunnel release. Improvement in pain and function after cubital tunnel release may be associated with an improvement in symptoms both within and outside the ulnar nerve distribution. Future studies could be directed at correlating pre-operative disease severity with probability of extra-territorial symptom resolution using a larger sample population.

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Acknowledgements

The authors wish to thank Ruth L. Chimenti, Ph.D.; D.P.T. for the assistance with appropriate statistical testing of research hypotheses.

Conflict of Interest

Peter C. Chimenti declares that he has no conflicts of interest.

Allison W. McIntyre declares that she has no conflicts of interest.

Sean M. Childs declares that he has no conflicts of interest.

Warren C. Hammert declares that he has no conflicts of interest.

John C. Elfar has funding from NIH grant number 1 K08 AR060164-01A.

Statement of Human and Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Statement of Informed Consent

Informed consent was obtained from all patients who were included in the study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Rochester Medical Center, 601 Elmwood Avenue, Box 665, Rochester, NY, 14642, USA

    Peter C. Chimenti, Allison W. McIntyre, Sean M. Childs, Warren C. Hammert & John C. Elfar

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  1. Peter C. Chimenti
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  2. Allison W. McIntyre
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  3. Sean M. Childs
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  4. Warren C. Hammert
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  5. John C. Elfar
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Correspondence to John C. Elfar.

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Chimenti, P.C., McIntyre, A.W., Childs, S.M. et al. Prospective cohort study of symptom resolution outside of the ulnar nerve distribution following cubital tunnel release. HAND 10, 177–183 (2015). https://doi.org/10.1007/s11552-014-9688-9

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  • DOI: https://doi.org/10.1007/s11552-014-9688-9

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