title: Prospective cohort study of symptom resolution outside of the ulnar nerve distribution following cubital tunnel release.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Orthopaedic Surgery, University of Rochester Medical Center, 601 Elmwood Avenue, Box 665, Rochester, NY 14642 USA.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Chimenti
authors.affiliation: Department of Orthopaedic Surgery, University of Rochester Medical Center, 601 Elmwood Avenue, Box 665, Rochester, NY 14642 USA.
authors.forename: Allison W
authors.initials: AW
authors.lastname: McIntyre
authors.affiliation: Department of Orthopaedic Surgery, University of Rochester Medical Center, 601 Elmwood Avenue, Box 665, Rochester, NY 14642 USA.
authors.forename: Sean M
authors.initials: SM
authors.lastname: Childs
authors.affiliation: Department of Orthopaedic Surgery, University of Rochester Medical Center, 601 Elmwood Avenue, Box 665, Rochester, NY 14642 USA.
authors.forename: Warren C
authors.initials: WC
authors.lastname: Hammert
authors.affiliation: Department of Orthopaedic Surgery, University of Rochester Medical Center, 601 Elmwood Avenue, Box 665, Rochester, NY 14642 USA.
authors.forename: John C
authors.initials: JC
authors.lastname: Elfar
keywords: Cubital tunnel syndrome; Extra-ulnar; Ulnar nerve; Ulnar neuropathy