The management of cubital tunnel syndrome: A meta-analysis of clinical studies

Despite extensive clinical experience in treating cubital tunnel syndrome, optimal surgical management remains controversial. A meta-analysis of 30 st udies with accurate preoperative and postoperative staging was undertaken. Patients were staged preoperatively into minimum, moderate, and severe grou ps on the basis of clinical presentation. Treatment modalities included non operative management, surgical decompression, medial epicondylectomy, anter ior subcutaneous transposition, and anterior submuscular transposition. Sta tistical analysis using a standard SAS database with analysis of variance a nd chi-square tests was used to assess the efficacy of each therapeutic mod ality. For minimum-staged patients, all modalities produced similar degrees of satisfaction. However, total relief occurred most after medial epicondy lectomy and least after anterior subcutaneous transposition. Patients treat ed nonoperatively had the highest rate of recurrence. For moderate-staged p atients, submuscular transposition was most efficacious, whereas patients w ith nonoperative management fared the worst. Finally, for severe-staged pat ients, current therapeutic modalities were not consistently effective, with medial epicondylectomy producing the poorest operative result. This articl e reveals statistically significant differences in outcomes among therapeut ic modalities, which may assist in treatment planning; it introduces standa rdized methods to aid in determining analyzing, and communicating treatment outcomes.