Predictors of surgical outcomes after in situ ulnar nerve decompression for cubital tunnel syndrome

Figures & data

Table 1 Details of Messina’s criteria

Messina’s criteria
Excellent	Complete resolution of symptoms with no postoperative motor or sensory deficit
Good	General resolution of symptoms but occasional tenderness at the incision site, mild residual decreased sensibility, or residual motor weakness
Fair	Improvement after surgery but with persistent sensory changes, residual motor loss, muscle wasting, or persistent claw deformity
Poor	No improvement after the surgical procedure or worsening of symptoms

Table 2 A comparison of variables in patients with satisfactory and unsatisfactory outcomes

Variable	Unsatisfactory group (n=27)	Satisfactory group (n=208)	P-value
Age (years)	54.1±11.3	53.2±10.6	0.681
Gender			0.830
Male	17	137
Female	10	71
BMI (kg/m^2)	24.1±3.1	23.5±2.7	0.287
Tobacco use			0.649
Yes	6	59
No	21	149
Alcohol use			0.614
Yes	4	42
No	23	166
Hypertension			0.438
Yes	7	39
No	20	169
Diabetes mellitus			0.748
Yes	2	23
No	25	185
Disease duration (months)	17.1±6.7	13.8±7.4	0.029
Preoperative severity			0.004
Severe	25	137
Not severe	2	71
MCV (m/s)	28.2±10.5	34.1±12.8	0.023
SCV (m/s)	23.4±11.7	27.6±8.4	0.021

Abbreviations: BMI, body mass index; MCV, motor conduction velocity; SCV, sensory conduction velocity.

Table 3 Multivariate logistic regression analysis of risk factors for poor recovery

Variable	OR	95% CI	P-value
Disease duration ≥12 months	2.14	0.75–6.16	0.156
Severe preoperative symptom	3.06	2.16–4.32	<0.001
MCV (m/s)	1.22	0.87–1.72	0.248
SCV (m/s)	1.04	0.68–1.58	0.863

Abbreviations: OR, odds ratio; CI, confidence interval; MCV, motor conduction velocity; SCV, sensory conduction velocity.

Table 4 Multivariate logistic regression analysis of risk factors for postoperative ulnar nerve instability

Variable	OR	95% CI	P-value
Age ≤40 years	2.41	1.63–3.58	<0.001
Male gender	1.93	0.62–5.97	0.25
BMI ≥25 kg/m^2	1.19	0.67–2.08	0.56

Abbreviations: OR, odds ratio; CI, confidence interval; BMI, body mass index.

Table 5 Summary of previous reports on risk factors for poor surgical outcomes following ulnar nerve decompression

Study	Year	Study design	No of patients	Surgical strategy	Identified risk factors
Yamamoto et al^Citation14	2006	Retrospective	107	Simple decompression, anterior transposition	Age, duration of disease, preoperative severity, and motor nerve conduction velocity
Krogue et al^Citation13	2015	Retrospective	231	Simple decompression	Prior elbow fracture
Kang et al^Citation12	2016	Prospective	41	Simple decompression, anterior transposition	Older age, worse preoperative grip strength, and worse two-point discrimination
Bruder et al^Citation11	2017	Retrospective	42	Simple decompression, anterior transposition	Duration of disease
Suzuki et al^Citation10	2017	Retrospective	125	Simple decompression, anterior transposition, medial epicondylectomy	Preoperative severity

YamamotoKShishidoTMasaokaTKatoriYTanakaSPostoperative clinical results in cubital tunnel syndromeOrthopedics20062934735316628995

 PubMed Web of Science ®Google Scholar

KrogueJDAleemAWOseiDAGoldfarbCACalfeeRPPredictors of surgical revision after in situ decompression of the ulnar nerveJ Shoulder Elbow Surg20152463463925660241

 PubMed Web of Science ®Google Scholar

KangHJOhWTKohIHKimSChoiYRFactors influencing outcomes after ulnar nerve stability-based surgery for cubital tunnel syndrome: a prospective cohort studyYonsei Med J20165745546026847300

 PubMed Web of Science ®Google Scholar

BruderMDutzmannSRekkabNMuscular atrophy in severe cases of cubital tunnel syndrome: prognostic factors and outcome after surgical treatmentActa Neurochir (Wien)201715953754228110402

 PubMed Web of Science ®Google Scholar

SuzukiTIwamotoTShizuKPredictors of postoperative outcomes of cubital tunnel syndrome treatments using multiple logistic regression analysisJ Orthop Sci20172245345628153376

 PubMed Web of Science ®Google Scholar