Artikel
Surgery for cubital tunnel syndrome in patients with diabetes – a prospective study of patient reported outcome measurements using national quality registries
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Autoren
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Malin Zimmerman
- Department of Translational Medicine - Hand Surgery, Lund University, Skåne University Hospital, Malmö, Sweden
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Ilka Anker
- Department of Translational Medicine - Hand Surgery, Lund University, Skåne University Hospital, Malmö, Sweden
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Erika Nyman
- Department of Clinical and Experimental Medicine, Department of Hand Surgery, Plastic Surgery and Burns, Linköping, Sweden
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Marianne Arner
- HAKIR, Department of Hand Surgery, South General Hospital, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden
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Ann-Marie Svensson
- National Diabetes Register, Centre of Registers, Gothenburg, Sweden
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Lars B. Dahlin
- Department of Translational Medicine - Hand Surgery, Lund University, Skåne University Hospital, Malmö, Sweden
| Veröffentlicht: | 6. Februar 2020 |
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Gliederung
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Objectives/Interrogation: To evaluate if diabetes affects outcome after surgical treatment for cubital tunnel syndrome.
Methods: Data from the National Quality Register for hand surgery procedures (HAKIR) were combined with data from the Swedish National Diabetes Register (NDR) to evaluate patients who had surgery for cubital tunnel syndrome 2010 - 2016. Outcome was assessed by QuickDASH (Disabilities of Arm, Shoulder and Hand) preoperatively, and at three and 12 months postoperatively. A simple linear regression was used to predict QuickDASH scores at 12 months based on the following variables: diabetes, gender, type of surgery (simple decompression or transposition) and age at time of surgery. Mann-Whitney U-test with post hoc Bonferroni correction and Chi2 were used to compare groups. Each treated hand was analysed as a separate statistical entity.
Results and Conclusions: During the study period, 1394 cases were surgically treated for cubital tunnel syndrome.
We found no significant differences in QuickDASH scores between cases with or without diabetes (Table 1 [Tab. 1]), neither pre-operatively nor postoperatively, irrespective of type of diabetes. No differences in QuickDASH scores were observed between those with and without diabetic retinopathy.
Patients' QuickDASH scores at 12 months increased by 9 (95% CI 3-14; p=0.002) points if the patient was a female and by 11 points (95% CI 2-19; p=0.019) if the surgical method was a transposition. Patients with diabetes had a smaller improvement in QuickDASH scores than patients without diabetes (Table 1 [Tab. 1]).
Patients with diabetes benefit from surgical treatment for cubital tunnel syndrome almost to the same extent as patients without diabetes, regardless of type 1 or type 2 diabetes. Presence of retinopathy did not influence outcome among cases with diabetes. A higher risk for residual problems, as defined by higher postoperative QuickDASH scores, was observed in females and after ulnar nerve transpositions.
