Treatment options for ulnar neuropathy at the elbow (UNE) are extensive, but controversy exists over the effectiveness of these procedures, including simple decompression, decompression and medial epicondylectomy, subcutaneous anterior transposition, intramuscular anterior transposition, and submuscular anterior transposition. Previous studies, many of which are retrospective reviews, have not determined if outcomes are superior for any particular procedure. Furthermore, outcomes are usually reported subjectively and none have used validated questionnaires to evaluate outcomes. In contrast, a great deal of information has been collected for outcomes following carpal tunnel syndrome, which is highly dependent on patient-rated questionnaires. Advances in the treatment of UNE depend on determining the validity and responsiveness of current outcomes questionnaires. We plan to conduct a prospective study to assess outcomes, the trend of recovery and the predictors of outcomes for simple decompression of the ulnar nerve for UNE. We plan to assess the responsiveness of 3 commonly used questionnaires for the hand: the Carpal Tunnel Questionnaire, the Disabilities of the Arm, Shoulder and Hand Questionnaire, and the Michigan Hand Outcomes Questionnaire in assessing outcomes for this surgical procedure. These data will help determine the effectiveness of this procedure and the time sequence for improvement after surgery to help guide physicians and patients in the decision-making process when faced with this common disease.

Public Health Relevance

With an estimated prevalence of 1%, ulnar neuropathy at the elbow is the second most common upper extremity peripheral neuropathy next to carpal tunnel syndrome. Despite years of outcomes research on this syndrome, the literature supporting one treatment over another is inconclusive. Evidence-based practices are needed, and advances in the treatment of ulnar neuropathy at the elbow will first depend on determining the validity and responsiveness of current outcomes questionnaires.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Postdoctoral Individual National Research Service Award (F32)
Project #
5F32AR058105-02
Application #
8130706
Study Section
Special Emphasis Panel (ZRG1-F16-G (20))
Program Officer
Panagis, James S
Project Start
2010-08-05
Project End
2012-06-30
Budget Start
2011-08-05
Budget End
2012-06-30
Support Year
2
Fiscal Year
2011
Total Cost
$49,062
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Surgery
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Song, Jae W; Mitchell, Paul D; Kolasinski, James et al. (2015) Asymmetry of White Matter Pathways in Developing Human Brains. Cereb Cortex 25:2883-93
Song, Jae W; Waljee, Jennifer F; Burns, Patricia B et al. (2013) An outcome study for ulnar neuropathy at the elbow: a multicenter study by the surgery for ulnar nerve (SUN) study group. Neurosurgery 72:971-81; discussion 981-2; quiz
Giladi, Aviram M; Gaston, R Glenn; Haase, Steven C et al. (2013) Trend of recovery after simple decompression for treatment of ulnar neuropathy at the elbow. Plast Reconstr Surg 131:563e-73e
Malay, Sunitha; SUN Study Group; Chung, Kevin C (2013) The minimal clinically important difference after simple decompression for ulnar neuropathy at the elbow. J Hand Surg Am 38:652-9
Song, Jae W; Chung, Kevin C; Prosser, Lisa A (2012) Treatment of ulnar neuropathy at the elbow: cost-utility analysis. J Hand Surg Am 37:1617-1629.e3
Chung, Kevin C; Song, Jae W; Shauver, Melissa J et al. (2011) Certification examination cases of candidates for certification by the American Board of Plastic Surgery: trends in practice profiles spanning a decade (2000 to 2009). Plast Reconstr Surg 128:568-76
Chung, Kevin C; Shauver, Melissa J; Song, Jae W et al. (2011) Adherence to practice guidelines based on American Board of Plastic Surgery Maintenance of Certification data. Plast Reconstr Surg 127:2101-7
Song, Jae W; Kim, Hyungjin Myra; Bellfi, Lillian T et al. (2011) The effect of study design biases on the diagnostic accuracy of magnetic resonance imaging for detecting silicone breast implant ruptures: a meta-analysis. Plast Reconstr Surg 127:1029-44
Chung, Kevin C; Song, Jae W; Kim, H Myra et al. (2010) Predictors of job satisfaction among academic faculty members: do instructional and clinical staff differ? Med Educ 44:985-95
Fang, Frank; Song, Jae W; Chung, Kevin C (2010) Discussion. Refining outcomes in dorsal hand coverage: consideration of aesthetics and donor-site morbidity. Plast Reconstr Surg 126:1639-41

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