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Luxation du nerf ulnaire lors du syndrome canalaire au coude. Influence sur le résultat chirurgical

Anker, I. LU ; Zimmerman, M. LU orcid ; Nyman, E. LU and Dahlin, L. B. LU orcid (2022) In Hand Surgery and Rehabilitation 41(1). p.96-102
Abstract

Our aim was to assess the incidence of symptomatic ulnar nerve dislocation and its influence on surgical outcome after primary and revision surgeries in ulnar nerve entrapment at the elbow (ulnar neuropathy at the elbow (UNE) or cubital tunnel syndrome). The influence of pre- or intra-operative ulnar nerve dislocation on postoperative outcome was assessed in 548 surgically treated cases (548 nerves) from two hand surgery departments reporting to the Swedish National Quality Registry for Hand Surgery, using QuickDASH, a patient-reported outcome measure (PROM), before surgery and at 3 and 12 months postoperatively, and a doctor-reported outcome measure (DROM), grading as “cured-improved “or “unchanged-worsened,” at a median follow-up of... (More)

Our aim was to assess the incidence of symptomatic ulnar nerve dislocation and its influence on surgical outcome after primary and revision surgeries in ulnar nerve entrapment at the elbow (ulnar neuropathy at the elbow (UNE) or cubital tunnel syndrome). The influence of pre- or intra-operative ulnar nerve dislocation on postoperative outcome was assessed in 548 surgically treated cases (548 nerves) from two hand surgery departments reporting to the Swedish National Quality Registry for Hand Surgery, using QuickDASH, a patient-reported outcome measure (PROM), before surgery and at 3 and 12 months postoperatively, and a doctor-reported outcome measure (DROM), grading as “cured-improved “or “unchanged-worsened,” at a median follow-up of 3.0 months [IQR, 1.5–6.0]. 109 of the 548 cases (20%) showed documented pre- or intra-operative ulnar nerve dislocation; more often found at revision (35/75, 47%) than at primary surgery (74/473, 16%) (p < 0.0001). Cases with dislocation presented higher QuickDASH scores at 12 months (p = 0.026). A linear regression model, adjusted for age and gender, predicted higher QuickDASH scores at 12 months postoperatively for cases with dislocation (unstandardized B 11.3 [95% CI 0.4–22.2], p = 0.043). DROM grading as unchanged-worsened at a median 3 months predicted worse QuickDASH scores (p < 0.0001) than in cured-improved cases at 3 (unstandardized B, 18.4 [95% CI 9.4–27.3]) and 12 months (unstandardized B, 18.1 [9.1–27.0]). Primary surgeries had better DROM grading than revision surgeries (p = 0.033; cured-improved, 75% and 63%, respectively), but QuickDASH scores did not differ. Presence of a clinically relevant ulnar nerve dislocation resulted in worse outcome, perhaps due to more extensive surgery with transposition. Nerve dislocation needs attention when treating UNE patients.

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author
; ; and
organization
alternative title
Ulnar nerve dislocation in ulnar nerve entrapment at the elbow. Influence on surgical outcome
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cubital tunnel syndrome, QuickDASH score, Simple nerve decompression, Ulnar nerve dislocation, Ulnar nerve entrapment, Ulnar nerve transposition
in
Hand Surgery and Rehabilitation
volume
41
issue
1
pages
96 - 102
publisher
Elsevier
external identifiers
  • scopus:85116537405
  • pmid:34583086
ISSN
2468-1229
DOI
10.1016/j.hansur.2021.09.003
language
French
LU publication?
yes
additional info
Publisher Copyright: © 2021 SFCM
id
df46a15e-a52e-4922-9c68-89ace3e81765
date added to LUP
2021-10-27 11:05:22
date last changed
2024-06-15 19:29:39
@article{df46a15e-a52e-4922-9c68-89ace3e81765,
  abstract     = {{<p>Our aim was to assess the incidence of symptomatic ulnar nerve dislocation and its influence on surgical outcome after primary and revision surgeries in ulnar nerve entrapment at the elbow (ulnar neuropathy at the elbow (UNE) or cubital tunnel syndrome). The influence of pre- or intra-operative ulnar nerve dislocation on postoperative outcome was assessed in 548 surgically treated cases (548 nerves) from two hand surgery departments reporting to the Swedish National Quality Registry for Hand Surgery, using QuickDASH, a patient-reported outcome measure (PROM), before surgery and at 3 and 12 months postoperatively, and a doctor-reported outcome measure (DROM), grading as “cured-improved “or “unchanged-worsened,” at a median follow-up of 3.0 months [IQR, 1.5–6.0]. 109 of the 548 cases (20%) showed documented pre- or intra-operative ulnar nerve dislocation; more often found at revision (35/75, 47%) than at primary surgery (74/473, 16%) (p &lt; 0.0001). Cases with dislocation presented higher QuickDASH scores at 12 months (p = 0.026). A linear regression model, adjusted for age and gender, predicted higher QuickDASH scores at 12 months postoperatively for cases with dislocation (unstandardized B 11.3 [95% CI 0.4–22.2], p = 0.043). DROM grading as unchanged-worsened at a median 3 months predicted worse QuickDASH scores (p &lt; 0.0001) than in cured-improved cases at 3 (unstandardized B, 18.4 [95% CI 9.4–27.3]) and 12 months (unstandardized B, 18.1 [9.1–27.0]). Primary surgeries had better DROM grading than revision surgeries (p = 0.033; cured-improved, 75% and 63%, respectively), but QuickDASH scores did not differ. Presence of a clinically relevant ulnar nerve dislocation resulted in worse outcome, perhaps due to more extensive surgery with transposition. Nerve dislocation needs attention when treating UNE patients.</p>}},
  author       = {{Anker, I. and Zimmerman, M. and Nyman, E. and Dahlin, L. B.}},
  issn         = {{2468-1229}},
  keywords     = {{Cubital tunnel syndrome; QuickDASH score; Simple nerve decompression; Ulnar nerve dislocation; Ulnar nerve entrapment; Ulnar nerve transposition}},
  language     = {{fre}},
  number       = {{1}},
  pages        = {{96--102}},
  publisher    = {{Elsevier}},
  series       = {{Hand Surgery and Rehabilitation}},
  title        = {{Luxation du nerf ulnaire lors du syndrome canalaire au coude. Influence sur le résultat chirurgical}},
  url          = {{http://dx.doi.org/10.1016/j.hansur.2021.09.003}},
  doi          = {{10.1016/j.hansur.2021.09.003}},
  volume       = {{41}},
  year         = {{2022}},
}