Nonoperative management of cubital tunnel syndrome: an 8-year prospective study.
This study reports the results of a prospective trial of nonoperative management of the cubital tunnel syndrome in 128 patients. Forty-three of the patients had bilateral ulnar nerve compression. At study's end, information was available on 94% of patients and 164 managed extremities, at a mean of 58.6 months of follow-up. We scored the degree of severity of cubital tunnel syndrome numerically, based on concepts of the pathophysiology of chronic nerve compression. For statistical purposes, a successful outcome of the nonoperative regimen was not having an operation. Life-table analysis demonstrated that 89% of patients with symptoms only, 67% of patients with abnormal sensorimotor thresholds, and 38% of patients with abnormal sensorimotor innervated density did not have surgery. These differences were significant (p < 0.001) by both parametric and nonparametric analysis. A history of elbow injury significantly worsened outcome (p < 0.02), but the results of the pretreatment electrodiagnosis did not. We conclude that a strict nonoperative regimen be supervised in the initial management of the cubital tunnel syndrome.
Dellon
A L
AL
Division of Plastic Surgery, Johns Hopkins Hospital, Baltimore, MD.
Hament
W
W
Gittelshon
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000601:surgery / Q000628:therapy*; D011446:Prospective Studies; D016896:Treatment Outcome; D014459:Ulnar Nerve