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Clinical outcomes of combined surgical treatment of medial epicondylitis and cubital tunnel syndrome.

Authors
  • Mooney, M1
  • Andrews, K2
  • Rowland, A2
  • Jain, M3
  • Mustapha, A A2
  • Skie, M2
  • 1 The University of Toledo Medical Center, Department of Orthopedic Surgery, 3000, Arlington avenue, Toledo, OH 43614, USA. Electronic address: [email protected]
  • 2 The University of Toledo Medical Center, Department of Orthopedic Surgery, 3000, Arlington avenue, Toledo, OH 43614, USA.
  • 3 Salmon Medical Center, Department of Orthopedic Surgery, 2200, NW Myhre road, Silverdale, WA 98383, USA.
Type
Published Article
Journal
Hand surgery & rehabilitation
Publication Date
Oct 01, 2019
Volume
38
Issue
5
Pages
298–301
Identifiers
DOI: 10.1016/j.hansur.2019.08.001
PMID: 31404681
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Surgical results for treatment of medial epicondylitis and cubital tunnel syndrome are generally satisfactory when performed alone. However, our experience suggests a combined procedure is associated with inferior outcomes. A retrospective review was conducted of consecutive surgical cases of medial epicondylectomy/debridement and ulnar nerve decompression during a single operation at our institution from March 2008 to February 2017 using CPT codes. Thirty combined procedures were identified in 29 patients. Fourteen patients and 15 elbows returned to clinic for evaluation at average 4.3 years after surgery (8 men, 6 women, mean age 45.1 years). A Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, visual analogue pain scale (VAS), and physical examination were performed. The data was stratified by type of ulnar nerve procedure and analyzed. Three of fifteen elbows underwent in situ ulnar nerve decompression, and twelve of 15 had transposition, five subcutaneous and seven submuscular. The mean DASH score for in situ decompression was significantly higher than that of transposition (68.2 vs. 13.1). The average visual pain score for patients whom underwent in situ decompression was significantly higher than that of those with ulnar nerve transposition (8.0 vs. 1.2). All other physical exam measures demonstrated no significant difference between the two groups. In situ ulnar nerve decompression in the setting of medial epicondylectomy/debridement may be associated with inferior clinical outcomes in comparison to ulnar nerve transposition. Further studies are needed to validate the results of our study and inform management. Copyright © 2019 SFCM. Published by Elsevier Masson SAS. All rights reserved.

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