Setting expectations following endoscopic cubital tunnel release

Area of Science:

• Orthopedic Surgery
• Neurosurgery
• Hand Surgery

Background:

• Cubital tunnel syndrome is a common condition affecting the ulnar nerve at the elbow.
• Surgical interventions include endoscopic cubital tunnel release (ECuTR) and anterior transposition of the ulnar nerve (ATUN).
• Evaluating recovery characteristics is crucial for patient management and healthcare economics.

Purpose of the Study:

• To compare return-to-work times between ECuTR and ATUN.
• To assess patient satisfaction and factors influencing it post-ECuTR.
• To determine the resolution rates of preoperative symptoms and findings after ECuTR.
• To investigate the impact of preoperative ulnar nerve subluxation on ECuTR outcomes.

Main Methods:

• Prospective enrollment of 172 cases (148 patients) undergoing ECuTR.
• Kaplan-Meier analysis for return-to-work time comparison with a historical ATUN cohort.
• Preoperative and postoperative evaluation of subjective and objective symptoms.
• Classification of cases using Dellon's and Bishop's systems.

Main Results:

• ECuTR patients returned to work significantly faster (8 days) than ATUN patients (71 days).
• Male sex, manual labor, and worker's compensation negatively impacted return-to-work.
• High symptom resolution rates observed: 86% for weakness, 81% for pain, 79% for numbness/tingling.
• Dellon's classification predicted postoperative satisfaction; ulnar nerve subluxation had no significant effect.

Conclusions:

• ECuTR demonstrates superior return-to-work times, offering significant economic benefits through reduced lost productivity.
• Patient satisfaction and symptom resolution are linked to preoperative cubital tunnel syndrome severity (Dellon's classification).
• ECuTR is an effective treatment option for cubital tunnel syndrome, particularly for improving return-to-work metrics.