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.
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.
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