Predictors of Functional Outcomes After Simple Decompression for Ulnar Neuropathy at the Elbow: A Multicenter Study by the SUN Study Group |
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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 |
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Affiliation: | 1. Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI;2. Center for Statistical Consultation and Research, University of Michigan, Ann Arbor, MI;3. OrthoCarolina Hand Center, Department of Orthopedic Surgery, Charlotte, NC;4. Department of Orthopedic Surgery, University of Rochester Medical Center, Rochester, NY;5. Department of Orthopaedic Surgery, University of Michigan Health System, Ann Arbor, MI;6. Indiana Hand to Shoulder Center, Indianapolis, IN;g Drisko Fee and Parkins Orthopedics, North Kansas City, MO;h Department of Neurosurgery, University of Michigan Health System, Ann Arbor, MI |
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Abstract: | ObjectiveTo identify predictors of surgical outcome for ulnar neuropathy at the elbow (UNE).DesignProspective cohort followed for 1 year.SettingClinics.ParticipantsPatients diagnosed with UNE (N=55).InterventionAll subjects had simple decompression surgery.Main Outcome MeasuresThe primary outcome measure was patient-reported outcomes, such as overall hand function through the Michigan Hand Outcomes Questionnaire (MHQ). Predictors included age, duration of symptoms, disease severity, and motor conduction velocity across the elbow.ResultsMultiple regression models with change in the overall MHQ score as the dependent variable showed that at 3 months postoperative time, patients with <3 months duration of symptoms showed 12 points (95% confidence interval [CI], 0.9–23.5) greater improvement in MHQ scores than those with ≥3 months symptom duration. Less than 3 months of symptoms was again associated with 13 points (95% CI, 2.9–24) greater improvement in MHQ scores at 6 months postoperative, but it was no longer associated with better outcomes at 12 months. A worse baseline MHQ score was associated with significant improvement in MHQ scores at 3 months (coefficient, −0.38; 95% CI, −.67 to −.09), and baseline MHQ score was the only significant predictor of 12 month MHQ scores (coefficient, −.40; 95% CI, −.79 to −.01).ConclusionsSubjects with <3 months of symptoms and worse baseline MHQ scores showed significantly greater improvement in functional outcomes as reported by the MHQ. However, duration of symptoms was only predictive at 3 or 6 months because most patients recovered within 3 to 6 months after surgery. |
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Keywords: | Outcome assessment (health care) Rehabilitation |
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