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Susan E. Mackinnon - One of the best experts on this subject based on the ideXlab platform.

  • beyond the Cubital Tunnel use of adjunctive procedures in the management of Cubital Tunnel syndrome
    Hand, 2021
    Co-Authors: Adam G Evans, William M Padovano, Megan J M Patterson, Matthew D Wood, Warangkana Fongsri, Carie R Kennedy, Susan E. Mackinnon
    Abstract:

    Background:Our management of Cubital Tunnel syndrome has expanded to involve multiple adjunctive procedures, including supercharged end-to-side anterior interosseous to ulnar nerve transfer, cross-...

  • pain and function following revision Cubital Tunnel surgery
    Hand, 2019
    Co-Authors: Kristen M Davidge, Gregory C Ebersole, Susan E. Mackinnon
    Abstract:

    Background The purpose of this study was to determine pain and functional outcomes following revision Cubital Tunnel surgery and to identify predictors of poor postoperative outcome. Methods A retrospective cohort study was conducted of all patients undergoing revision Cubital Tunnel surgery over a 5-year period at a high-volume peripheral nerve center. Intraoperative findings, demographic and injury factors, and outcomes were reviewed. Average pain, worst pain, and impact of pain on self-perceived quality of life were each measured using a 10-cm visual analog scale (VAS). Function was evaluated using pinch and grip strength, as well as the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Differences in preoperative and postoperative pain, strength, and DASH were analyzed using nonparametric tests. Predictors of postoperative average pain were evaluated using odds ratios and linear regression analyses. Results The final cohort consisted of 50 patients (mean age: 46.3 ± 12.5 years; 29 [68%] male) undergoing 52 revision ulnar nerve transpositions (UNTs). Pain VAS scores decreased significantly following revision UNT. Strength and DASH scores demonstrated nonsignificant improvements postoperatively. Worse preoperative pain and greater than 1 prior Cubital Tunnel procedure were significant predictors of worse postoperative average pain VAS scores. Conclusions Patients can and do improve following revision Cubital Tunnel surgery, particularly as it relates to pain. Intraoperative findings during the revision procedure suggest that adherence to specific principles in the primary operation is key to prevention of secondary Cubital Tunnel syndrome.

  • scratch collapse test for evaluation of carpal and Cubital Tunnel syndrome
    Journal of Hand Surgery (European Volume), 2008
    Co-Authors: Christine J Cheng, Brendan Mackinnonpatterson, John L Beck, Susan E. Mackinnon
    Abstract:

    Purpose The purpose of this study was to evaluate the clinical usefulness of a new test, the scratch collapse test , for the diagnosis of carpal Tunnel syndrome and Cubital Tunnel syndrome. Methods The scratch collapse test was prospectively compared with Tinel's sign and flexion/nerve compression in 169 patients and 109 controls. One hundred nineteen patients were diagnosed with carpal Tunnel syndrome and 70 patients were diagnosed with Cubital Tunnel syndrome based on history, examination, and positive electrodiagnostic test. For the new test, the patient resisted bilateral shoulder external rotation with elbows flexed. The area of suspected nerve compression was lightly "scratched," and then resisted shoulder external rotation was immediately repeated. Momentary loss of shoulder external rotation resistance on the affected side was considered a positive test. The sensitivity, specificity, and predictive values were calculated. Results For carpal Tunnel syndrome, sensitivities were 64%, 32%, and 44% for the scratch collapse test, Tinel's test, and wrist flexion/compression test, respectively. For Cubital Tunnel syndrome, sensitivities were 69%, 54%, and 46% for the scratch collapse test, Tinel test, and elbow flexion/compression test, respectively. The scratch collapse test had the highest negative predictive value (73%) for carpal Tunnel syndrome. Tinel's test had the highest negative predictive value (98%) for Cubital Tunnel syndrome. Specificity and positive predictive values were high for all of the tests. Conclusions The scratch collapse test had significantly higher sensitivity than Tinel's test and the flexion/nerve compression test for carpal Tunnel and Cubital Tunnel syndromes. Accuracy for this test was 82% for carpal Tunnel syndrome and 89% for Cubital Tunnel syndrome. This novel test provides a useful addition to existing clinical maneuvers in the diagnosis of these common nerve compression syndromes. Type of study/level of evidence Diagnostic II.

  • Selection of Operative Procedures for Cubital Tunnel Syndrome
    Hand (New York N.Y.), 2008
    Co-Authors: Christine B. Novak, Susan E. Mackinnon
    Abstract:

    The purpose of this study was to investigate the primary operative procedures that are performed by hand surgeons for Cubital Tunnel syndrome and their reported satisfaction with these procedures. The survey consisted of 22 questions regarding primary operative treatment of Cubital Tunnel syndrome and demographics and was sent by email to the 459 active members of the American Association for Hand Surgery. One hundred sixty-four surgeons completed the survey (36% response rate). The total sample included 154 hand surgeons (143 males, 11 females) who operated on Cubital Tunnel syndrome and the majority of surgeons were in private practice (n = 100) followed by academic practice (n = 50). The most prevalent factors that influence the decision to operate include evidence of muscle atrophy (84%), abnormal nerve conduction studies (51%), and failed non-operative treatment (49%). Most surgeons (n = 133) reported using more than one operative procedure for their patients with Cubital Tunnel syndrome. Factors that influenced the operative procedure selected included the degree of nerve compression (60%), medical comorbidities (30%), patient’s occupation (28%), and obesity (22%). Following carpal Tunnel surgery, 88% of the surgeons were “very satisfied” with their patient outcome and following surgery for Cubital Tunnel syndrome, only 44% were “very satisfied” with their patient outcome. Most surgeons use more than one operative procedure in their treatment of patients with Cubital Tunnel syndrome and the selection of the operative procedure is influenced by patient factors and surgeon preference.

  • Current approach to Cubital Tunnel syndrome.
    Neurosurgery clinics of North America, 2001
    Co-Authors: James B. Lowe, Christine B. Novak, Susan E. Mackinnon
    Abstract:

    The choice for surgical treatment of Cubital Tunnel syndrome is no clearer today than when it was reviewed 10 years ago. There continue to be no significant prospective randomized trials to adequately compare the different surgical techniques. Even if such a trial were performed, most hand surgeons would probably continue to be skeptical. In the end, each surgeon must rely on his or her own personal experience or judgment. Based on the authors' experience in the treatment of Cubital Tunnel syndrome, they are confident that anterior transmuscular transposition of the ulnar nerve obtains the best results when the preoperative algorithm is properly applied and early postoperative physical therapy is instituted.

Ryan P. Calfee - One of the best experts on this subject based on the ideXlab platform.

  • Cubital Tunnel Syndrome: Current Concepts.
    The Journal of the American Academy of Orthopaedic Surgeons, 2017
    Co-Authors: Jonathan Robert Staples, Ryan P. Calfee
    Abstract:

    Cubital Tunnel syndrome is the second most common upper extremity compressive neuropathy. In recent years, rates of surgical treatment have increased, and the popularity of in situ decompression has grown. Nonsurgical treatment, aiming to decrease both compression and traction on the ulnar nerve about the elbow, is successful in most patients with mild nerve dysfunction. Recent randomized controlled trials assessing rates of symptom resolution and ultimate success have failed to identify a preferred surgical procedure. Revision Cubital Tunnel surgery, most often consisting of submuscular transposition, may improve symptoms. However, ulnar nerve recovery after revision Cubital Tunnel surgery is less consistent than that after primary Cubital Tunnel surgery.

  • the management of Cubital Tunnel syndrome
    Journal of Hand Surgery (European Volume), 2015
    Co-Authors: Sean Boone, Richard H Gelberman, Ryan P. Calfee
    Abstract:

    Symptomatic Cubital Tunnel syndrome is a condition that frequently prompts patients to seek hand surgical care. Although Cubital Tunnel syndrome is readily diagnosed, achieving complete symptom resolution remains challenging. This article reviews related anatomy, clinical presentation, and current management options for Cubital Tunnel syndrome with an emphasis on contemporary outcomes research.

Bing-sheng Liang - One of the best experts on this subject based on the ideXlab platform.

  • The treatment strategies of Cubital Tunnel syndrome
    Chinese Journal of Hand Surgery, 2012
    Co-Authors: Guo-dong Yang, Deng-feng Zhang, Wen-kai Chang, Bing-sheng Liang
    Abstract:

    Objective To compare the efficacy of two surgical procedures for Cubital Tunnel syndrome and propose a more rational surgical treatment option.Methods A retrospective review of 77 cases with severe Cubital Tunnel syndrome treated in our hospital from August 2005 to January 2011 was conducted.They were treated with one of the two methods:neurolysis and subfascial anterior transposition of the ulnar nerve or neurolysis and subcutaneous anterior transposition of the ulnar nerve.42 cases were treated with the former and 35 cases with the latter.Preoperatively the severity of the cases was assessed using GU's classification.During postoperative follow-up the functions were evaluated by the Cubital Tunnel syndrome evaluation criteria.Results Postoperative follow-up period ranged from 3 months to 6 years,with an average of 2.5 years.The majority of cases were in remission after 3 to 4 months.No further improvement was observed thereafter.According to the Cubital Tunnel syndrome evaluation criteria,functional recovery was excellent in 42 cases,good in 25 cases,fair in 8 cases and poor in 2 cases.The excellent rate was 54.5％,while the overall satisfactory rate was 87.0％.The results of subfascial anterior transposition cases were significantly better than those of subcutaneous anterior transposition cases (P ＜ 0.05).Conclusion Anterior transposition of the ulnar nerve under a fascial flap is a preferred surgical technique for treatment of Cubital Tunnel syndrome. Key words: Cubital Tunnel syndrome;  Treatment outcome;  Follow-up studies

Lin Shi - One of the best experts on this subject based on the ideXlab platform.

  • Analysis the cause of failure in primary surgery of Cubital Tunnel syndrome and clinical evaluation of revision Cubital Tunnel surgery
    Chinese Journal of Hand Surgery, 2019
    Co-Authors: Rui Zhao, Rui Cong, Tong Tian, Yong Zhao, Lin Shi
    Abstract:

    Objective To explore the reasons for the failure of primary Cubital Tunnel syndrome (CuTS) surgery, summarize the technical details of Cubital Tunnel revision and evaluate the clinical efficacy. Methods From January 2015 to December 2016, 20 patients with persistent or new symptoms of CuTS after primary operation were treated with revision. The technical details of revision of Cubital Tunnel were summarized and the clinical efficacy was evaluated by observing the compression of ulnar nerve during operation and following up the improvement of clinical symptoms. Results The incomplete release of common compression points of ulnar nerve in elbow and improper preparation of fascial tissue flaps for anterior ulnar nerve were the main reasons for the failure of operation. After at least 12 months of follow-up, the strength of hand intrinsic muscles, skin sensation and pain symptoms of ulnar nerve innervation were significantly improved. Conclusion For the cases of CuTS with severe symptoms or new symptoms after primary operation, the main reason for failure is improper handling of details. The clinical efficacy of revision of CuTS is satisfactory, but it is worse than that of successful primary surgery. Key words: Cubital Tunnel syndrome; Treatment failure; Revision; Neuropathic pain; Medial antebrachial cutaneous nerve

Guo-dong Yang - One of the best experts on this subject based on the ideXlab platform.

  • The treatment strategies of Cubital Tunnel syndrome
    Chinese Journal of Hand Surgery, 2012
    Co-Authors: Guo-dong Yang, Deng-feng Zhang, Wen-kai Chang, Bing-sheng Liang
    Abstract:

    Objective To compare the efficacy of two surgical procedures for Cubital Tunnel syndrome and propose a more rational surgical treatment option.Methods A retrospective review of 77 cases with severe Cubital Tunnel syndrome treated in our hospital from August 2005 to January 2011 was conducted.They were treated with one of the two methods:neurolysis and subfascial anterior transposition of the ulnar nerve or neurolysis and subcutaneous anterior transposition of the ulnar nerve.42 cases were treated with the former and 35 cases with the latter.Preoperatively the severity of the cases was assessed using GU's classification.During postoperative follow-up the functions were evaluated by the Cubital Tunnel syndrome evaluation criteria.Results Postoperative follow-up period ranged from 3 months to 6 years,with an average of 2.5 years.The majority of cases were in remission after 3 to 4 months.No further improvement was observed thereafter.According to the Cubital Tunnel syndrome evaluation criteria,functional recovery was excellent in 42 cases,good in 25 cases,fair in 8 cases and poor in 2 cases.The excellent rate was 54.5％,while the overall satisfactory rate was 87.0％.The results of subfascial anterior transposition cases were significantly better than those of subcutaneous anterior transposition cases (P ＜ 0.05).Conclusion Anterior transposition of the ulnar nerve under a fascial flap is a preferred surgical technique for treatment of Cubital Tunnel syndrome. Key words: Cubital Tunnel syndrome;  Treatment outcome;  Follow-up studies