Return to Activity Following Isolated Ulnar Nerve Surgery: A Systematic Review

Area of Science:

• Orthopedic Surgery
• Neurology
• Sports Medicine

Background:

• Ulnar neuropathy is a common mononeuropathy with varied surgical treatment strategies.
• A definitive surgical approach for ulnar nerve issues remains debated.
• Return to play or activity is a key outcome measure for surgical interventions.

Purpose of the Study:

• To systematically review literature on return to play or activity outcomes.
• To assess outcomes of in situ decompression, subcutaneous transposition, and submuscular transposition for ulnar nerve neuritis or neuropathy.
• To hypothesize that isolated ulnar nerve transposition or decompression leads to high return-to-activity rates.

Main Methods:

• Systematic literature review from 1975-2023 using multiple databases (PubMed, MEDLINE, etc.).
• Inclusion criteria: studies reporting return to play/activity after isolated ulnar nerve transposition or decompression for neuritis.
• Exclusion criteria: concomitant ulnar collateral ligament injury or revision surgery.

Main Results:

• 12 studies (1977-2021) involving 358 patients met inclusion criteria.
• Overall successful return to play/activity/work reported in 84.6% of patients.
• Return rates: Submuscular transposition (95%), subcutaneous transposition (87.9%), in situ decompression (75.5%).

Conclusions:

• Ulnar nerve transposition or decompression without concomitant ulnar collateral ligament pathology demonstrates an 84.6% return to activity rate.
• Surgical intervention for ulnar nerve issues provides favorable outcomes.
• Appropriate surgical indications and techniques are crucial for successful return to activity.