OBJECTIVE: To determine the outcome in patients with ulnar neuropathy at the elbow (UNE) treated surgically or conservatively, and the prognostic value of clinical, sonographic, and electrophysiologic features. METHODS: After a median follow-up of 14 months, 69 of 84 patients initially included in a prospective blinded study on the diagnostic value of sonography in UNE were re-evaluated. The patients underwent renewed systematic clinical and sonographic examination. Patients were scored as having a poor (stable or progressive symptoms) or favorable (complete remission of symptoms or improvement) outcome. RESULTS: Of the 74 initially affected arms, 12 (16%) had a complete remission, 21 (28%) improved, 25 (34%) remained stable, and 16 (22%) had progression. Surgically treated patients (28 arms) had a more favorable outcome than those treated conservatively (p = 0.03). After surgery, the mean ulnar nerve diameter decreased from 3.2 to 2.9 mm (p = 0.03), while this was not seen after conservative treatment. Multiple logistic regression analysis showed that more outspoken nerve enlargement found during sonography at the time of the diagnosis was associated with a poor outcome (OR: 2.9, p = 0.009). Furthermore, the presence of a motor conduction block (OR: 0.2, p = 0.03) and motor velocity slowing across the elbow (OR: 0.1, p = 0.01) were associated with a favorable outcome. CONCLUSION: More pronounced ulnar nerve thickening at the time of the diagnosis is associated with poor outcome at follow-up, especially in conservatively treated cases, while electrodiagnostic signs of demyelination on testing indicate favorable outcome.
OBJECTIVE: To determine the outcome in patients with ulnar neuropathy at the elbow (UNE) treated surgically or conservatively, and the prognostic value of clinical, sonographic, and electrophysiologic features. METHODS: After a median follow-up of 14 months, 69 of 84 patients initially included in a prospective blinded study on the diagnostic value of sonography in UNE were re-evaluated. The patients underwent renewed systematic clinical and sonographic examination. Patients were scored as having a poor (stable or progressive symptoms) or favorable (complete remission of symptoms or improvement) outcome. RESULTS: Of the 74 initially affected arms, 12 (16%) had a complete remission, 21 (28%) improved, 25 (34%) remained stable, and 16 (22%) had progression. Surgically treated patients (28 arms) had a more favorable outcome than those treated conservatively (p = 0.03). After surgery, the mean ulnar nerve diameter decreased from 3.2 to 2.9 mm (p = 0.03), while this was not seen after conservative treatment. Multiple logistic regression analysis showed that more outspoken nerve enlargement found during sonography at the time of the diagnosis was associated with a poor outcome (OR: 2.9, p = 0.009). Furthermore, the presence of a motor conduction block (OR: 0.2, p = 0.03) and motor velocity slowing across the elbow (OR: 0.1, p = 0.01) were associated with a favorable outcome. CONCLUSION: More pronounced ulnar nerve thickening at the time of the diagnosis is associated with poor outcome at follow-up, especially in conservatively treated cases, while electrodiagnostic signs of demyelination on testing indicate favorable outcome.
Authors: Patricia B Burns; H Myra Kim; R Glenn Gaston; Steven C Haase; Warren C Hammert; Jeffrey N Lawton; Greg A Merrell; Paul F Nassab; Lynda J Yang; Kevin C Chung Journal: Arch Phys Med Rehabil Date: 2013-11-16 Impact factor: 3.966
Authors: Mariana Balikova; Marta Neklanova; Igor Sulla; Martin Hönig; Jan Halek; Vladimir Mihal; Vladimir Balik Journal: Childs Nerv Syst Date: 2017-03-01 Impact factor: 1.475
Authors: Murat Kutlay; Ahmet Colak; Hakan Simşek; Ersin Oztürk; Mehmet Güney Senol; Kivanç Topuz; Mehmet Nusret Demircan Journal: Neurosurg Rev Date: 2008-09-17 Impact factor: 3.042
Authors: Philipp Bäumer; Markus Weiler; Maurice Ruetters; Frank Staub; Thomas Dombert; Sabine Heiland; Martin Bendszus; Mirko Pham Journal: PLoS One Date: 2012-11-14 Impact factor: 3.240
Authors: H Stephan Goedee; W Ludo van der Pol; Jan-Thies H van Asseldonk; Alexander F J E Vrancken; Nicolette C Notermans; Leo H Visser; Leonard H van den Berg Journal: Neurol Clin Pract Date: 2016-08
Authors: Nurcan Üçeyler; Kristina A Schäfer; Daniel Mackenrodt; Claudia Sommer; Wolfgang Müllges Journal: Front Neurol Date: 2016-03-30 Impact factor: 4.003