gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Longterm outcome after Ulner Tunnel Release

Meeting Abstract

  • presenting/speaker R. F. Westenberg - Massachusetts General Hospital, Boston, United States
  • N. C. Chen - Massachusetts General Hospital, Boston, United States
  • Daphne Van Hooven - Massachusetts General Hospital, Boston, United States

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1437

doi: 10.3205/19ifssh0795, urn:nbn:de:0183-19ifssh07953

Published: February 6, 2020

© 2020 Westenberg et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives/Interrogation: Ulnar tunnel syndrome (UTS) is a rare nerve compression syndrome with a variety of causative factors. The aims of this study are to describe the distribution of causes of ulnar tunnel syndrome, the rate of revision, and to evaluate the long-term outcome of ulnar tunnel release (UTR) in patients with UTS.

Methods: We identified 225 patients using Current Procedural Terminology code 64719 at two urban hospitals between 1/1/2003 and 12/31/2016. After manual chart review we included 143 adult patients with UTS. We excluded 54 patients with a direct injury of the ulnar nerve, four patients who had an UTR because of an infection and two patients who had an incomplete medical chart. Our retrospective cohort consists of 81 patients, of which 27 patients completed a follow up survey. The mean±SD age at surgery was 53.5±15.6 years and 39 (46.4%) patients were men. Fifty-one patients (63.0%) had an UTR and another concomitant nerve decompression procedure or carpectomy (Figure 1).The median time to last clinical visit was 4.6 months (IQR 1.8 -12.1) and the mean±SD to the follow up questionnaire is 7.1±32. years.

Results and Conclusions: The intra-operative findings for the cause of compression was ganglion cyst in 12 patients (15%), fibrous or muscular compression in 19 patients (23.5%), scar tissue in seven patients (8.6%), tumor in guyon canal in three patients (3.7%), compression by the pisohamate ligament in four patients (4.9%), bony impingement in two patients (2.5%) and unclear in 31 patients (38.3%). Two (2.5%) patients had a revision ulnar tunnel release. At time of last clinical visit, 18 (22%) patients still had residual pain, 57 (70%) had residual sensory or motor symptoms but 67 (82.7%) were noted to be improved (Figure 2). The mean±SD PROMIS score of all patients that had a UTR was 45.2±11.9 and 47.4±14.1 for all patients that solely had an decompression of Guyon canal (Table 1). The follow-up questionnaire revealed that 23 patients (85.2%) improved after UTR and that 25 (92.5%) would have the same surgery again if they were in the same situation.

Patients with UTS improve after UTR but residual symptoms may remain. Despite residual symptoms most patients would choose to have surgical treatment again if they were in the same situation again.