Purpose
This study was designed to test the hypothesis that patients with an initial diagnosis
of cubital tunnel syndrome are more likely to present with muscle atrophy than patients
with an initial diagnosis of carpal tunnel syndrome.
Methods
A list of patients presenting to the office of a single hand surgeon from January
2000 to June 2005 with an initial diagnosis of isolated, idiopathic carpal tunnel
syndrome or cubital tunnel syndrome was generated from billing records. The medical
records of 58 patients with cubital tunnel syndrome and 370 patients with carpal tunnel
syndrome were reviewed for age, gender, diabetes, and presence of atrophy.
Results
Twenty-three of 58 patients with an initial diagnosis of cubital tunnel syndrome had
atrophy compared with only 62 out 370 patients with an initial diagnosis of carpal
tunnel syndrome. Multiple logistic regression revealed that age (odds ratio, 1.06;
95% CI, 1.04–1.08) and diagnosis (cubital tunnel patients were more likely than carpal
tunnel patients to present with atrophy; odds ratio, 4.5; 95% CI, 2.7–8.6) were factors
significantly associated with atrophy at presentation.
Conclusions
Patients with carpal tunnel syndrome present earlier in the course of their disease
than patients with cubital tunnel syndrome. Patients with cubital tunnel syndrome
are more likely to present with muscle atrophy, reflecting advanced nerve damage that
may not respond to surgery.
Type of study/level of evidence
Prognostic IV.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Hand SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Incidence of common compressive neuropathies in primary care.J Neurol Neurosurg Psychiatry. 2006; 77: 263-265
- Incidence of ulnar neuropathy at the elbow in the province of Siena (Italy).J Neurol Sci. 2005; 234: 5-10
- Results of treatment of severe carpal-tunnel syndrome without internal neurolysis of the median nerve.J Bone Joint Surg. 1987; 69A: 896-903
- Patient-reported outcome after carpal tunnel release for advanced disease: a prospective and longitudinal assessment in patients older than age 70.J Hand Surg. 2004; 29A: 379-383
- Long-term clinical and neurologic recovery in the hand after surgery for severe cubital tunnel syndrome.J Hand Surg. 2004; 29A: 373-378
- Clinical and neurophysiological outcome of surgery in extreme carpal tunnel syndrome.Clin Neurophysiol. 2001; 112: 1237-1242
- The management of cubital tunnel syndrome: a meta-analysis of clinical studies.Plast Reconstr Surg. 2000; 106: 327-334
- Results of internal neurolysis of the median nerve for severe carpal-tunnel syndrome.J Bone Joint Surg. 1985; 67A: 253-256
- Cubital tunnel syndrome.JAMA. 1979; 241: 801-802
- Side-to-side confrontational strength-testing for weakness of the intrinsic muscles of the hand.J Bone Joint Surg. 1997; 79A: 401-405
- Estimating sample size and power: the nitty-gritty.in: Hulley S. Cummings S. Browner W. Grady D. Hearst N. Newman T. Designing clinical research. 2nd ed. Lippincott Williams & Wilkins, Philadelphia2001: 65-91
- Applied logistic regression. 2nd ed. John Wiley, New York2000: 92-128
Article info
Publication history
Accepted:
March 16,
2007
Received:
September 2,
2006
Footnotes
Supported by unrestricted research grants from AO Foundation, Wright Medical, Joint Active Systems, Smith and Nephew Richards, and Small Bone Innovations.
Identification
Copyright
© 2007 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
