title: Outcomes Following Cubital Tunnel Surgery in Young Patients: The Importance of Nerve Mobility.
abstract: OBJECTIVE
  To investigate the outcomes following surgical management of unstable and stable ulnar nerves at the elbow in young patients.
  
  
  METHODS
  We retrospectively reviewed the charts of 67 patients who were 30 years old or younger when they underwent primary cubital tunnel surgery at our institution over a 10-year period. In 34 (45%) of these patients, the ulnar nerve either subluxated or perched on the medial epicondyle with elbow flexion and made up the "unstable" cohort. The remaining 42 patients made up the "stable" cohort. Preoperative, intraoperative, and postoperative data were obtained from the patients' charts. Thirty-nine patients completed the following outcome measures: Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), visual analog scale (VAS) for pain and treatment satisfaction, return to sport or full activities, and the presence of persistent symptoms.
  
  
  RESULTS
  At an average of 5.6 years following surgery, the unstable cohort had a significantly lower QuickDASH score (6.4 vs 18.6) and a significantly higher VAS for treatment satisfaction (8.7 vs 5.9) compared with the stable cohort. The unstable cohort was also significantly less likely to experience residual symptoms (43% vs 94%), persistent numbness (39% vs 44%), or persistent tingling (22% vs 56%) compared with the stable cohort. Within the stable cohort, patients who underwent simultaneous carpal tunnel release exhibited improved VAS and QuickDASH scores compared with patients who did not. There were no differences in time to return to sports or full activities or pain VAS between the two groups.
  
  
  CONCLUSIONS
  Surgical management of young patients with symptomatic, unstable ulnar nerves results in superior subjective outcomes compared with surgery in young patients with stable ulnar nerves.
  
  
  METHODS
  Therapeutic III.
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, MO.
authors.forename: Curtis M
authors.initials: CM
authors.lastname: Henn
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, MO.
authors.forename: Aalok
authors.initials: A
authors.lastname: Patel
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, MO.
authors.forename: Lindley B
authors.initials: LB
authors.lastname: Wall
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, MO. Electronic address: goldfarbc@wudosis.wustl.edu.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Goldfarb
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D020430:Cubital Tunnel Syndrome / Q000503:physiopathology / Q000601:surgery*; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D008297:Male; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D014459:Ulnar Nerve / Q000503:physiopathology*; D055815:Young Adult
keywords: Cubital tunnel; nerve instability; subluxating ulnar nerve