Luxation du nerf ulnaire lors du syndrome canalaire au coude. Influence sur le résultat chirurgical
(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.
(Less)
- author
- Anker, I. LU ; Zimmerman, M. LU ; Nyman, E. LU and Dahlin, L. B. LU
- organization
- alternative title
- Ulnar nerve dislocation in ulnar nerve entrapment at the elbow. Influence on surgical outcome
- publishing date
- 2022
- 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
- 2024-09-22 04:27:21
@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 < 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.</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}}, }