Cubital Tunnel Syndrome
Conditions
Brief summary
Cubital tunnel syndrome is caused by compression of the ulnar nerve at the elbow. This leads to symptoms such as chronic hand weakness, numbness and pain. This is usually treated with a surgical procedure where the nerve is decompressed. Research has shown that nerve simulators speed up the recovery of nerves following injury. The purpose of our research is to examine the difference in patient outcomes after the nerve decompression surgery with and without nerve stimulation. Our research questions is: What are the differences in long term functional outcomes of patients that have ulnar nerve decompression surgery with and without nerve stimulation?
Detailed description
1. Patients will be seen in University of Chicago clinics, if they are diagnosed with Cubital Tunnel Syndrome, they will be approached to be enrolled in our study 2. If they fit inclusion and exclusion criteria, failed conservative management, and consent to be part of the study, they will be scheduled for Cubital Tunnel Surgery and randomized into intervention/non-intervention group 3. Patients will have pre-operative subjective pain and upper extremity function surveys and objective hand strength/sensation measurements done by a blinded Occupational Therapist in University of Chicago Occupational Therapy Clinic. Patient will also have a pre-operative EMG done. 4. Patient will be discharged following surgery and followed up at 6 weeks, 3 months, 6 months, 12 months. EMG will be done at 3 months and the same outcome measurements (Pain scores, PRUNE evaluation, QuickDash Questionnaire, Michigan hand Questionnaire, grip strength, sensation measurements) will be taken at each postoperative visit by the same blinded occupational therapist 5. Data will be compared pre and postoperatively
Interventions
DEVICEUlnar Nerve Stimulation
1 hour of continued stimulation of the ulnar nerve using a hand held stimulator
Sponsors
University of Chicago
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* EMG confirmed ulnar nerve neuropathy at cubital tunnel with or without these symptoms: * Paresthesia or numbness of the small finger and/or ring finger * Complaints of hand weakness * Exam shows positive flexion compression test at elbow and/or positive tinel's sign at the cubital tunnel * Failed conservative management for 6 weeks ○ Has completed a combination of these for 6 weeks and still has symptoms * Night splinting in 45-60 degrees of flexion and forearm neutral * Padding of elbow with an elbow pad during the day * Daily NSAIDs if able to take them * Cubital tunnel steroid injection * Age restriction: 18--65years old
Exclusion criteria
* Psychiatric conditions * Workman's compensation patients * Neurologic conditions (ex. MS) * Inflammatory rheumatologic conditions (Connective tissues disease, RA… etc) * Associated elbow and upper extremity fractures * Previous Cubital Tunnel Surgeries * Previous C-Spine Surgeries * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patient Related Ulnar Nerve Evaluation | 10 minutes | PRUNE Survey with 0-100 score |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| QuickDASH | 10 minutes, pre op and each post op visit | Survey |
| Michigan Hand Questionnaire | 20 minutes, pre op and each post op visit | Survey |
Other
| Measure | Time frame | Description |
|---|---|---|
| Pinch Strength | 5 minutes, pre op and each post op visit | Measure Pinch strength |
| EMG | Pre-op and 3 month post op visit | Electromyelopgraph to confirm ulnar nerve neuropathy and improvement at 3 months post op |
| Grip strength | 5 minutes, pre op and each post op visit | Measure hand grip strength |
| Monofilament test | 5 minutes, pre op and each post op visit | Measure sensation on fingers |
| 2 point discrimination | 5 minutes, pre op and each post op visit | Measure 2 point discrimination on fingers |
Countries
United States
Outcome results
None listed