title: Predicting Revision Following In Situ Ulnar Nerve Decompression for Patients With Idiopathic Cubital Tunnel Syndrome.
abstract: OBJECTIVE
  To determine the incidence of revision and potential risk factors for needing revision surgery following in situ ulnar nerve decompression for patients with idiopathic cubital tunnel syndrome (CTS).
  
  
  METHODS
  We conducted a retrospective chart review of all patients treated at 1 specialty hand center with an open in situ ulnar nerve decompression for idiopathic CTS from January 2006 through December 2010. Revision incidence was determined by identifying patients who underwent additional surgeries for recurrent or persistent ulnar nerve symptoms. Bivariate analysis was performed to determine which variables had a significant influence on the need for revision surgery.
  
  
  RESULTS
  Revision surgery was required in 3.2% (7 of 216) of all cases. Age younger than 50 years at the time of index decompression was the lone significant predictor of need for revision surgery. Other patient factors, including gender, diabetes, smoking history, and workers' compensation status were not predictive of the need for revision surgery. Disease-specific variables including nerve conduction velocities, McGowan grading, and predominant symptom type were also not predictive of revision.
  
  
  CONCLUSIONS
  For patients with idiopathic CTS, the risk of revision surgery following in situ ulnar nerve decompression is low. However, this risk was increased in patients who were younger than 50 years at the time of the index procedure. The findings of this study suggest that, in the absence of underlying elbow arthritis or prior elbow trauma, in situ ulnar nerve decompression is an effective, minimal-risk option for the initial surgical treatment of CTS.
  
  
  METHODS
  Prognostic III.
authors.affiliation: The Philadelphia Hand Center, PC, Philadelphia, PA; Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA. Electronic address: michaelpgaspar@gmail.com.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Gaspar
authors.affiliation: The Philadelphia Hand Center, PC, Philadelphia, PA; Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Kane
authors.affiliation: The Philadelphia Hand Center, PC, Philadelphia, PA.
authors.forename: Dechporn
authors.initials: D
authors.lastname: Putthiwara
authors.affiliation: The Philadelphia Hand Center, PC, Philadelphia, PA; Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.
authors.forename: Sidney M
authors.initials: SM
authors.lastname: Jacoby
authors.affiliation: The Philadelphia Hand Center, PC, Philadelphia, PA; Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.
authors.forename: A Lee
authors.initials: AL
authors.lastname: Osterman
mesh_terms: D020430:Cubital Tunnel Syndrome / Q000601:surgery*; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014459:Ulnar Nerve / Q000601:surgery*
keywords: Cubital tunnel syndrome; decompression; in situ release; revision surgery; ulnar nerve