Sonographic Examination Cubital Tunnel Release
- Conditions
- Ulnar Nerve Compression, Cubital Tunnel
- Interventions
- Procedure: Cubital tunnel release
- Registration Number
- NCT02739945
- Lead Sponsor
- Ente Ospedaliero Cantonale, Bellinzona
- Brief Summary
The investigators want to compare changes in cross-sectional area (CSA) of the ulnar nerve at the elbow after open release or endoscopic release.
- Detailed Description
The investigators want to compare changes in CSA of the ulnar nerve at the elbow hypothesizing that US examination is a useful tool to detect unsuccessful release and defining which technique shows the best outcome in the first year postoperatively.
The measurement of cross-sectional area (CSA) as a diagnostic tool to detect entrapments syndrome in upper limbs has already been described. US typically demonstrates an abrupt narrowing and displacement of the nerve within the tunnel, possibly in association with a thickened retinaculum or a space-occupying lesions. Previous studies prospectively compared sonographic outcomes after decompression of the median nerve at the wrist.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 60
- history of paresthesia or numbness in the ulnar nerve distribution;
- weakness or wasting of the small muscles of the hand;
- a positive elbow flexion provocation test;
- slowed motor conduction velocity in the ulnar nerve below 50 m/sec.
- Patients with normal nerve conduction studies;
- prior surgery for Cubital Tunnel Syndrome;
- prior traumatic lesions of the elbow;
- coexistent neurological diseases;
- bone anormalities (cubitus valgus, deformities from previous elbow fractures, osteoarthritis with medial osteophytes ands loose bodies, heterotopic ossifications);
- subluxating ulnar nerve;
- space-occupying soft-tissue lesions.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Open cubital tunnel release Cubital tunnel release In situ decompression (MacKinnon and Novak 2005) is made through a 6-10 cm longitudinal incision along the course of the ulnar nerve midway between the medial epicondyle and the olecranon. Endoscopic cubital tunnel release Cubital tunnel release Endoscopic release follows Hoffmann's technique (Hoffmann 2006) that demonstrated the safety and efficacy of this technique in a cadaveric model and in a clinical study.
- Primary Outcome Measures
Name Time Method American Shoulder and Elbow Society Function Score 12 months postoperatively. Patients undergoing surgical decompression indicate their postoperative clinical outcome with this scale
- Secondary Outcome Measures
Name Time Method Static-2 point discrimination test 12 months postoperatively. Two-point discrimination is the ability to discern that two nearby objects touching the skin are truly two distinct points.
Two-point discrimination has long been used as an assessment tool for tactile gnosis, and to assess recovery after a peripheral nerve surgery.4-point Likert-type scale 12 months postoperatively. Patients undergoing surgical decompression indicate their postoperative clinical outcome on a questionnaire using 4-point Likert-type scale (1= large improvement, 2 = moderate improvement, 3= no improvement, 4= worse than preoperatively)
Jamar dynamometer (grip strength) 12 months postoperatively. Quantitative measurement of grip strength were assessed with a Jamar dynamometer. The Jamar Dynamometer is an instrument for measuring the maximum isometric strength of the hand and forearm muscles. The Jamar dynamometer was introduced in 1954 (Bechtol,1954). It consists of a sealed hydraulic system with adjustable hand spacings that measures handgrip force
Trial Locations
- Locations (1)
Dr.Lucchina Stefano
🇨ðŸ‡Locarno, Canton Ticino, Switzerland