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Evaluating functional outcomes following hand therapy in cubital tunnel release
Joshua K Kim1, Crystal Jing1, Suhail K Mithani1
1Department of Surgery, Division of Plastic, Oral, and Maxillofacial Surgery, Duke University School of Medicine, Durham, NC, United States; Department of Orthopaedic Surgery, Division of Hand Surgery, Duke University School of Medicine, Durham, NC, United States.
Background:
Cubital tunnel syndrome is the second most common nerve compression of the upper extremity and requires procedural intervention in nearly half of cases. Postoperative hand therapy is inconsistently utilized, and functional benefits have not been well-characterized.
Purpose:
To investigate whether consistent therapy attendance improves postoperative functional outcomes and quantify the impact of socioeconomic factors on recovery.
Study Design:
Retrospective chart review.
Methods:
Patients at a single academic institution from 2014 to 2024 with cubital tunnel syndrome treated with surgical release were reviewed. Patient demographics, postoperative clinic visits, hand therapy attendance, Patient-Reported Outcomes Measurement Information System, and Quick Disabilities of the Arm, Shoulder, and Hand scores were tallied. Bivariate analysis compared patients attending four or more hand therapy sessions to those who did not. The area of deprivation was used to divide patients into two halves for analysis.
Results:
A total of 1396 patients were eligible for inclusion, with 461 (33.0%) attending hand therapy for 1 [1, 4] session. Among patients attending hand therapy, patients with consistent attendance had better Pain Interference, Upper Extremity Function, and subjective pain at 3 months and latest visit. Socioeconomically deprived patients had lower therapy and clinic attendance, with worse Physical Function, Pain Interference, and Upper Extremity Function 3 months postoperatively.
Conclusions:
Socioeconomic characteristics and natural functional recovery drive hand therapy engagement. In patients who require therapy, consistent attendance provided functional and pain benefits, particularly after 3 months. Poor socioeconomic status was associated with lower hand therapy attendance and worse functional outcomes.