PDF(Pubmed)
Abstract：
UNASSIGNED: The management of ulnar neuropathy remains unclear as there are neither consensus guidelines nor compelling data available to inform optimal treatment. Identifying patients in the mild-to-moderate group that would benefit most from surgery is challenging as their symptoms can be subtle and less debilitating. This study investigated predictors of surgical intervention among patients presenting with McGowan mild or moderate cubital tunnel syndrome (CuTS).
UNASSIGNED: This is an institutional review board-approved study. Patients evaluated from March 2016 to July 2022 were included if they were diagnosed with McGowan mild or moderate CuTS and underwent concurrent electrodiagnostic and ultrasound evaluations. Patient demographics, symptom presentation, and clinical and diagnostic test findings were analyzed. Variables were analyzed using Student t test, Mann-Whitney U test, or Pearson\'s chi-square test. Multivariable logistic regression was used to assess the association of covariates and surgery.
UNASSIGNED: Seventy-three patients and 103 elbows were identified. The mean age and body mass index were 51 years and 26.9, respectively. Most patients were men, right-handed, and unilaterally symptomatic in the dominant hand. Twenty-six elbows were surgically treated. Bivariable analyses by surgical treatment showed that patients who underwent surgery more often had positive electrodiagnostic findings including motor nerve conduction velocity <50 m/s and a >10 m/s conduction velocity difference across the forearm compared with elbow. Fifty-nine cases were categorized as electrodiagnostically normal. Of the electrodiagnostically normal cases, 29 had positive findings of CuTS on ultrasound. Logistic regression model showed that electrodiagnostically severe cases had 3.7 times higher odds of being surgically treated than normal counterparts (adjusted odds ratio, 3.7; 95% CI, 1.11-12.6; P = .03).
UNASSIGNED: Not many differences in objective findings identify patients who should receive operative treatment. In addition to test results, more subjective findings from patients such as patient-reported level of impairment may be able to bridge this gap in surgical decision making.
UNASSIGNED: This study contributes to treatment decision making for mild and moderate CuTS.
UNASSIGNED: This is an institutional review board-approved study. Patients evaluated from March 2016 to July 2022 were included if they were diagnosed with McGowan mild or moderate CuTS and underwent concurrent electrodiagnostic and ultrasound evaluations. Patient demographics, symptom presentation, and clinical and diagnostic test findings were analyzed. Variables were analyzed using Student t test, Mann-Whitney U test, or Pearson\'s chi-square test. Multivariable logistic regression was used to assess the association of covariates and surgery.
UNASSIGNED: Seventy-three patients and 103 elbows were identified. The mean age and body mass index were 51 years and 26.9, respectively. Most patients were men, right-handed, and unilaterally symptomatic in the dominant hand. Twenty-six elbows were surgically treated. Bivariable analyses by surgical treatment showed that patients who underwent surgery more often had positive electrodiagnostic findings including motor nerve conduction velocity <50 m/s and a >10 m/s conduction velocity difference across the forearm compared with elbow. Fifty-nine cases were categorized as electrodiagnostically normal. Of the electrodiagnostically normal cases, 29 had positive findings of CuTS on ultrasound. Logistic regression model showed that electrodiagnostically severe cases had 3.7 times higher odds of being surgically treated than normal counterparts (adjusted odds ratio, 3.7; 95% CI, 1.11-12.6; P = .03).
UNASSIGNED: Not many differences in objective findings identify patients who should receive operative treatment. In addition to test results, more subjective findings from patients such as patient-reported level of impairment may be able to bridge this gap in surgical decision making.
UNASSIGNED: This study contributes to treatment decision making for mild and moderate CuTS.
摘要：
■尺神经病变的治疗仍不清楚，因为既没有共识指南，也没有令人信服的数据来告知最佳治疗。确定从手术中受益最多的轻度至中度患者是具有挑战性的，因为他们的症状可能是微妙的且不那么使人衰弱。这项研究调查了McGowan轻度或中度肘管综合征（CuTS）患者手术干预的预测因素。
■这是一项机构审查委员会批准的研究。从2016年3月至2022年7月评估的患者如果被诊断为McGowan轻度或中度CuTS并同时接受电诊断和超声评估，则包括在内。患者人口统计学，症状表现,并对临床和诊断性检查结果进行分析。使用学生t检验分析变量，Mann-WhitneyU测试,或皮尔森卡方检验。多变量逻辑回归用于评估协变量和手术的关联。
■确定了73名患者和103个肘部。平均年龄和体重指数分别为51岁和26.9岁。大多数病人是男性,右撇子,优势手单方面有症状。手术治疗了26个肘部。通过手术治疗进行的双变量分析表明，与肘部相比，接受手术的患者更经常具有阳性的电诊断结果，包括运动神经传导速度<50m/s和前臂传导速度差>10m/s。59例被归类为电诊断正常。在电诊断正常病例中，29在超声上有CuTS阳性发现。Logistic回归模型显示，电诊断重症病例接受手术治疗的几率是正常病例的3.7倍（调整后的优势比，3.7；95%CI，1.11-12.6；P=0.03）。
■确定应接受手术治疗的患者的客观发现差异不多。除了测试结果，来自患者的更多主观发现,如患者报告的损伤程度,可能能够弥补手术决策中的这一差距.
■这项研究有助于轻度和中度CuTS的治疗决策。
■这是一项机构审查委员会批准的研究。从2016年3月至2022年7月评估的患者如果被诊断为McGowan轻度或中度CuTS并同时接受电诊断和超声评估，则包括在内。患者人口统计学，症状表现,并对临床和诊断性检查结果进行分析。使用学生t检验分析变量，Mann-WhitneyU测试,或皮尔森卡方检验。多变量逻辑回归用于评估协变量和手术的关联。
■确定了73名患者和103个肘部。平均年龄和体重指数分别为51岁和26.9岁。大多数病人是男性,右撇子,优势手单方面有症状。手术治疗了26个肘部。通过手术治疗进行的双变量分析表明，与肘部相比，接受手术的患者更经常具有阳性的电诊断结果，包括运动神经传导速度<50m/s和前臂传导速度差>10m/s。59例被归类为电诊断正常。在电诊断正常病例中，29在超声上有CuTS阳性发现。Logistic回归模型显示，电诊断重症病例接受手术治疗的几率是正常病例的3.7倍（调整后的优势比，3.7；95%CI，1.11-12.6；P=0.03）。
■确定应接受手术治疗的患者的客观发现差异不多。除了测试结果，来自患者的更多主观发现,如患者报告的损伤程度,可能能够弥补手术决策中的这一差距.
■这项研究有助于轻度和中度CuTS的治疗决策。
