Clinical features affecting the patient-based outcome after minimal medial epicondylectomy for cubital tunnel syndrome

Abstract

Background: Little information is currently available to analyze unsatisfactory surgical outcomes for cubital tunnel syndrome (CuTS). The aim of this study was to analyze the clinical features influencing patient-reported outcomes of minimal medial epicondylectomy for CuTS. Methods: We evaluated 91 patients who underwent minimal medial epicondylectomy for CuTS using the grip strength; two-point discrimination; Disability of the Arm, Shoulder and Hand (DASH) questionnaire; and a satisfaction with treatment questionnaire for one year, postoperatively. The clinical features evaluated as prognostic indicators included age, gender, body mass index (BMI), smoking, alcohol consumption, comorbidities, hand dominance, work level, history of elbow trauma, elbow arthritis, elbow flexion contracture, duration of symptoms, and severity of disease. Results: Grip strength, two-point discrimination, and DASH scores exhibited significant clinical improvements, with 77% (70/91) of patients satisfied with treatment. In terms of patient-reported disability, heavy smoking, elbow flexion contracture, and preoperative disease severity increased DASH scores at 1-year follow-up. However, only heavy smoking and elbow flexion contracture were associated with a higher likelihood of dissatisfaction with treatment. Conclusions: Heavy smoking, elbow flexion contracture, and preoperative disease severity are associated with persistently increased disability after minimal medial epicondylectomy for CuTS. However, only heavy smoking and elbow flexion contracture were associated with a higher likelihood of dissatisfaction with the treatment. (C) 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.