Neural Regeneration Research ›› 2019, Vol. 14 ›› Issue (3): 519-524.doi: 10.4103/1673-5374.245479

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Surgical treatment for severe cubital tunnel syndrome with absent sensory nerve conduction

Jin-Song Tong 1, 2, 3 , Zhen Dong 1, 2, 3 , Bin Xu 1, 2, 3 , Cheng-Gang Zhang 1, 2, 3 , Yu-Dong Gu 1, 2, 3   

  1. 1 Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
    2 Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China
    3 Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
  • Online:2019-03-15 Published:2019-03-15
  • Contact: Zhen Dong, MD, PhD, dongzhenhsh@163.com.
  • Supported by:

    This study was supported by the National Natural Science Foundation of China, No. 81371374 (to ZD).

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Abstract:

For severe cubital tunnel syndrome, patients with absent sensory nerve action potential tend to have more severe nerve damage than those without. Thus, it is speculated that such patients generally have a poor prognosis. How absent sensory nerve action potential affects sur¬gical outcomes remains uncertain owing to a scarcity of reports and conflicting results. One hundred and fourteen cases (88 patients with absent sensory nerve action potential and 26 patients with present sensory nerve action potential) were subjected to either subcutaneous transposition or in situ decompression. The minimum follow-up was set at 2 years. Primary outcome measures of overall hand function included their McGowan grade, modified Bishop score, and Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) score. For patients with absent sensory nerve action potential, 71 cases (80.7%) achieved at least one McGowan grade improvement, 76 hands (86.4%) got good or excellent results according to the Bishop score, and the average DASH score improved 49.5 points preoperatively to 13.1 points postoperatively. When compared with the present sensory nerve action potential group, they showed higher postoperative Mc¬Gowan grades and DASH scores, but there was no statistical difference between the modified Bishop scores of the two groups. Following in situ decompression or subcutaneous transposition, great improvement in hand function was achieved for severe cubital tunnel syn¬drome patients with absent sensory nerve action potential. The functional outcomes after surgery for severe cubital tunnel syndrome are worse in patients with absent sensory nerve action potential than those without. This study was approved by the Ethical Committee of Hua shan Hospital, Fudan University, China (approval No. 2017142).

Key words: nerve regeneration, absent sensory nerve action potential, cubital tunnel syndrome, disease severity, electrodiagnostic testing, in situ decompression, subcutaneous transposition, surgical outcomes, prognostic factors, peripheral nerve compression, neural regeneration