Effective surgical treatment of cubital tunnel syndrome based on provocative clinical testing without electrodiagnostics

Plastic and Reconstructive Surgery
Daniel GreenwaldBenjamin Cooper

Abstract

After studying this article, the participant should be able to: 1. Describe a method of clinical evaluation for accurate diagnosis of ulnar compression syndrome at the elbow. 2. Evaluate the accuracy and efficacy of the described method in diagnosing surgically correctable nerve entrapment. 3. Present a protocol for conservative management followed by surgical correction. 4. Discuss the results of the method and protocol in two series of patients treated by a single surgeon. This study of two patient populations addresses the effectiveness of identifying surgically correctable ulnar nerve compression at the elbow based on provocative clinical testing alone in patients with cubital tunnel syndrome after failure of conservative treatment. Twenty-four patients were included in the preliminary study (mean age, 60 years). Three of these patients underwent bilateral procedures. Patients complaining of symptoms in the distribution of the ulnar nerve were tested by elicitation of Tinel's sign and combined flexion and pressure testing at the elbow and wrist. Two-point discrimination was determined. After a failed 6-week trial of conservative therapy, patients underwent anterior submuscular transposition of the ulnar nerve with carpal tu...Continue Reading

References

Jul 1, 1989·The Journal of Hand Surgery·A L Dellon
Sep 1, 1994·The Journal of Hand Surgery·C B NovakL Lay
Feb 1, 1996·The Urologic Clinics of North America·G A Broderick

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Citations

Oct 13, 2011·Advances in Orthopedics·Birgitta SvernlövLars Adolfsson
Jul 6, 2014·Clinics in Plastic Surgery·Shu Guo Xing, Jin Bo Tang
Nov 5, 2013·The Journal of Hand Surgery·Ryan M ZimmermanJuan González del Pino
Nov 30, 2013·Hand Clinics·Horst Zajonc, Arash Momeni
Jun 3, 2015·Hand : Official Journal of the American Association for Hand Surgery·Peter C ChimentiJohn C Elfar
Feb 11, 2015·Journal of Shoulder and Elbow Surgery·Justin D KrogueRyan P Calfee
Feb 6, 2017·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Taku SuzukiKazuki Sato
Jan 14, 2017·Hand : Official Journal of the American Association for Hand Surgery·Matthew L DrakeKenneth F Taylor
Jan 26, 2010·Annals of Plastic Surgery·Sanjay NaranRonit Wollstein
May 8, 2018·The Journal of Hand Surgery Asian-Pacific Volume·Dimitrios SkouterisVassilios Psychoyios
Dec 30, 2014·Plastic and Reconstructive Surgery·David T TangSusan E Mackinnon
Jun 3, 2018·European Radiology·Łukasz PaluchPiotr Pietruski
Feb 2, 2010·The Journal of Hand Surgery·Bradley A Palmer, Thomas B Hughes

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