Artikel
Age, pathogenesis and the period from onset to surgery significantly affects the severity of cubital tunnel syndrome
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Autoren
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Takao Omura
- Hamamatsu University School of Medicine, Hamamatsu, Japan
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Takashi Ogawa
- Hamamatsu University School of Medicine, Hamamatsu, Japan
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Kaori Sugiura
- Hamamatsu University School of Medicine, Hamamatsu, Japan
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Ryo Okabayashi
- Hamamatsu University School of Medicine, Hamamatsu, Japan
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Michihito Miyagi
- Shizuoka Cancer Center, Nagaizumi, Japan
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Tomokazu Sawada
- Shizuoka City, Shizuoka Hospital, Shizuoka, Japan
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Hiroaki Ogihara
- Hamamatsu Red Cross Hospital, Hamamatsu, Japan
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Yukihiro Matsuyama
- Hamamatsu University School of Medicine, Hamamatsu, Japan
| Veröffentlicht: | 6. Februar 2020 |
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Gliederung
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Objectives/Interrogation: Cubital tunnel syndrome (CuTS) is symptomatic ulnar nerve dysfunction at the level of the elbow resulting from a combination of compression, traction, and friction. McGowan's classification is most frequently used to define the severity of CuTS. There are several causes of CuTS including osteoarthritis (OA) of the elbow, valgus of varus deformity after elbow fractures, subluxation of the ulnar nerve and constriction at arcuate ligament of Osborne. The severity of the CuTS is diverse due to the different causes of CuTS. The purpose of this study is to identify the characteristics of patients operated for CuTS, based on their severity of CuTS.
Methods: 107 patients who were operated under the diagnosis of CuTS at a single institute were included in this study. Apart from clinical examination, all the patients were examined with electrophysiological testing and a plain radiograph of the elbow. The analysis of the characteristics of CuTS included the cause of CuTS based on the operative findings, age, gender, time from onset to surgery. These factors were cross compared between different McGowan stages
Results and Conclusions: According to McGownan's classification, 11 patients were classified as grade I, 59 patients were classified as grade II and 37 were as grade III. The average age of the patients was significantly younger in grade I (47.7±4.3) in comparison with grade II (60.8±1.7) and III (63.3±2.0). As for the causes of CuTS, 45% was due to subluxation of the ulnar nerve and 18% was due to OA in grade I, whereas in grade II, OA was significantly higher in grade II followed by deformity after elbow fracture (11.9%). In grade III, the prevalence of OA also was also significantly higher (83.8%), followed by deformity after fracture (10.8%). The period from onset was significantly longer in patients with grade III (10.1 months) in comparison with grade I (6.7 months) and II (6.1).
Our result revealed that patients going under surgery at McGowan stage I are significantly younger and have less incidence of osteoarthritis. Although here is no significant difference in age and cause of CuTS between grade II and II patients, the period from onset to surgery is significantly longer in grade III patients. We conclude that age, pathogenesis and the period from onset to surgery significantly affects the severity of cubital tunnel syndrome.
