| Anterior transposition compared with simple decompression for treatment of cubital tunnel syndrome. A meta-analysis of randomized, controlled trials. | |
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MedLine Citation:
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PMID: 18056489 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: There is currently no consensus on the optimal operative treatment for cubital tunnel syndrome. The objective of this meta-analysis of randomized, controlled trials was to evaluate the efficacy of simple decompression compared with that of anterior transposition of the ulnar nerve in the treatment of this condition. METHODS: Multiple databases were searched for randomized, controlled trials on the outcome of operative treatment of cubital tunnel syndrome in patients who had not previously sustained trauma or undergone a surgical procedure involving the elbow. Two reviewers abstracted baseline characteristics, clinical scores, and motor nerve-conduction velocities independently. Data were pooled across studies, standard mean differences in effect sizes weighted by study sample size were calculated, and heterogeneity across studies was assessed. RESULTS: We identified four randomized, controlled trials comparing simple decompression with anterior ulnar nerve transposition (two submuscular and two subcutaneous). In three studies that included a total of 261 patients, a clinical scoring system was used as the primary clinical outcome. There were no significant differences between simple decompression and anterior transposition in terms of the clinical scores in those studies (standard mean difference in effect size = -0.04 [95% confidence interval = -0.36 to 0.28], p = 0.81). We did not find significant heterogeneity across these studies (I(2) = 34.2%, p = 0.22). Two reports, on a total of 100 patients, presented postoperative motor nerve-conduction velocities; they showed no significant differences between the procedures (standard mean difference in effect size = 0.24 [95% confidence interval -0.15 to 0.63] in favor of simple decompression, p = 0.23; I(2) = 0%, p = 0.9). CONCLUSIONS: The results of this meta-analysis suggest that there is no difference in motor nerve-conduction velocities or clinical outcome scores between simple decompression and ulnar nerve transposition for the treatment of ulnar nerve compression at the elbow in patients with no prior traumatic injuries or surgical procedures involving the affected elbow. Confidence intervals around the points of estimate were narrow, which probably exclude the possibility of clinically meaningful differences. These data suggest that simple decompression of the ulnar nerve is a reasonable alternative to anterior transposition for the surgical management of ulnar nerve compression at the elbow. |
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Authors:
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Michael Zlowodzki; Simon Chan; Mohit Bhandari; Loree Kalliainen; Warren Schubert |
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Publication Detail:
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Type: Comparative Study; Journal Article; Meta-Analysis |
Journal Detail:
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Title: The Journal of bone and joint surgery. American volume Volume: 89 ISSN: 1535-1386 ISO Abbreviation: J Bone Joint Surg Am Publication Date: 2007 Dec |
Date Detail:
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Created Date: 2007-12-06 Completed Date: 2008-01-22 Revised Date: 2010-10-25 |
Medline Journal Info:
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Nlm Unique ID: 0014030 Medline TA: J Bone Joint Surg Am Country: United States |
Other Details:
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Languages: eng Pagination: 2591-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue South, Room 200, Minneapolis, MN 55454, USA. zlowo001@umn.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cubital Tunnel Syndrome
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diagnosis,
physiopathology,
surgery* Decompression, Surgical* Humans Neural Conduction / physiology Neurosurgical Procedures Postoperative Period Randomized Controlled Trials as Topic / standards Severity of Illness Index Treatment Outcome Ulnar Nerve / physiology, surgery* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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