Outcomes may improve with cubital tunnel release regardless of electrodiagnostic diagnosis
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Key takeaways:
- QuickDASH scores significantly improved after cubital tunnel release regardless of electrodiagnostic testing.
- Negative electrodiagnostic testing yielded significantly greater improvement in QuickDASH scores.
Results presented at the American Society for Surgery of the Hand Annual Meeting showed patient-reported outcome measures were significantly improved after cubital tunnel release regardless of electrodiagnostic diagnosis.
“Our determination of how to diagnose cubital tunnel being solely reliant on electrodiagnostic testing is not good enough anymore. It is part of the reason why we are studying how to diagnose it with clinical entities and not necessarily just diagnostic entities, such as ultrasound and electrodiagnostic testing,” Michael B. Gottschalk, MD, professor of orthopedics at Emory University, told Healio. “Most patients live with [cubital tunnel syndrome] for much longer than we anticipate and probably should undergo surgery sooner than we thought.”
Gottschalk and colleagues retrospectively categorized patients with cubital tunnel syndrome into groups based on whether they had positive (n = 34) or negative (n = 23) electrodiagnostic testing prior to undergoing cubital tunnel release. Researchers compared demographics, preoperative and postoperative QuickDASH scores and change in QuickDASH scores between the two groups.
Results showed patients with negative electrodiagnostic testing had higher preoperative QuickDASH scores. However, researchers found this did not reach significance. Although both groups had significant improvements in QuickDASH scores after cubital tunnel release, results showed patients with negative electrodiagnostic testing had a significantly greater improvement in QuickDASH scores from preoperatively to 3 months postoperatively.
“We figured [patients] that had electrodiagnostic positive tests would be worse off, meaning they would have more ... myelin loss around the nerve,” Gottschalk said. “Even though that may not correlate directly with worse clinical symptoms at the time of surgery, that may be a subtle finding that we are not able to tease out as much clinically, but it seems to be borne out on the patient-reported outcomes side.”
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Gottschalk MB, et al. Paper 27. Presented at: American Society for Surgery of the Hand Annual Meeting; Sept. 19-21, 2024; Minneapolis.
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