Ulnar neuropathy at the elbow: Clinical and electrophysiological outcome of surgical and conservative treatment

The objective was to evaluate and compare the clinical and electrophysiolog ical outcome of treatment in patients with ulnar neuropathy at the elbow in 32 consecutive patients who were studied prospectively. Based on the elect rophysiological findings 15 patients were treated by surgical decompression and 17 were treated conservatively. Sensory and motor nerve conduction stu dies across and below the elbow were done in all patients before treatment and again after one year. Postoperatively 10/15 patients (67%) improved cli nically and 12 patients (80%) had improved nerve conduction results. There was clinical and electrophysiological agreement in eight patients in the su rgically-treated group, all of whom improved both clinically and electrophy siologically. In the conservatively-treated group six patients (35%) showed clinical improvement, 10 patients had no improvement, and one patient was worse. The nerve conduction studies improved in six patients (35%), were un changed in eight patients, and worse in three. There was clinical and elect rophysiological agreement in 11 patients. We conclude that the electrophysi ological examination was valuable in deciding which patients to operate on, and that most of the patients improved clinically or electrophysiologicall y postoperatively.