Clinical efficacy of decompression and anterior transposition of the ulnar nerve in osteoarthritis-induced cubital tunnel syndrome and influencing factors

Abstract

We aimed to explore the clinical efficacy of decompression and anterior transposition of the ulnar nerve in osteoarthritis-induced cubital tunnel syndrome (CTS). 109 patients with moderate-to-severe CTS treated from July 2015 to March 2019 were selected. Upper-limb function was scored. After ultrasound examination, decompression and anterior transposition of the ulnar nerve were performed; then ulnar nerve motor nerve conduction velocity (MNCV) was assessed. Patients were followed up every 3 months for 18 months and their prognosis was assessed. Upper-limb function examination results were compared according to disease severity. Univariate and multivariate regression analyses were conducted, and a nomogram prediction model was established. After treatment, the number of patients with intrinsic contracture of the hand, Tinel sign (+), clipping paper test (+) and Froment’s sign (+) significantly declined; hand grip strength, ulnar nerve MNCV, latency, amplitude, 2-point discrimination (2-PD) and Disabilities of the Arm, Shoulder and Hand (DASH) score were improved (p < 0.05). Age, gender, course of disease, long-term elbow bend work (LTEBW), ulnar nerve MNCV, 2-PD and DASH score were independent risk factors for poor prognosis (p < 0.05). The calibration curve confirmed that prognosis results after treatment were highly consistent with actual outcomes. Decompression and anterior transposition of the ulnar nerve exerted significant therapeutic effects on moderate-to-severe osteoarthritis-induced CTS. The nomogram prediction model established by age, gender, course of disease, LTEBW, ulnar nerve MNCV, 2-PD and DASH score can be used to effectively evaluate prognosis.