Efficacy of Submuscular Transposition for Revision Cubital Tunnel Release: Comparative Outcomes Analysis.

PURPOSE

To assess outcomes after revision cubital tunnel release and submuscular transposition and compare these to a cohort of patients undergoing primary release with in situ decompression.

METHODS

Patients who underwent revision cubital tunnel release and submuscular transposition (n = 16) were enrolled. Mean follow-up was 21.4 months (range 12.8-55.6). Patients were evaluated in person using the Michigan Hand Outcomes Questionnaire (MHQ) and Disabilities of the Arm, Shoulder and Hand (DASH). Dellon stage, McGowan grade, visual analog scale for pain, and improvement of symptoms using the Messina's criteria and Modified Bishop score were assessed. Comparative analysis was performed with a cohort of primary patients who underwent in situ decompression (n = 18), with a mean follow-up of 26.6 months (range 13.3-63.3).

RESULTS

In revision patients, postoperative improvement in Dellon stage was seen in 13 (81.3%) and McGowan grade in 12 (75.0%). Messina's criteria showed inferior but still satisfactory outcomes in the revision compared to primary cohort. Median MHQ was 57.1 (48.8-79.4) in the revision cohort and 76.3 (71.6-93.7) in the primary cohort. Median DASH was 26.3 (16.1-45.3) in the revision cohort and 11.7 (5.6-14.2) in the primary cohort. Differences between MHQ and DASH in both cohorts were statistically significant ( < .05). Median visual analog scale was 2.5 (0-6) in the revision cohort and 1.5 (0-4.5) in the primary cohort.

CONCLUSIONS

The majority of patients undergoing revision cubital tunnel release and submuscular transposition have relief of symptoms. However, improvement is incomplete and inferior compared to patients undergoing primary release.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.