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Conservative treatment of the cubital tunnel syndrome
Linköping University, Department of Clinical and Experimental Medicine, Plastic Surgery, Hand Surgery and Burns. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Plastic Surgery, Hand surgery UHL. (Landstinget i Östergötland)
(Landstinget i Östergötland)
Östergötlands Läns Landsting.
Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics and Sports Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Orthopaedic Centre, Department of Orthopaedics Linköping.
2009 (English)In: Journal of Hand Surgery: European Volume, ISSN 1753-1934, Vol. 34, no 2, 201-207 p.Article in journal (Refereed) Published
Abstract [en]

Conservative treatment of the cubital tunnel syndrome was evaluated in a randomised study of 70 patients with mild or moderate symptoms (Dellon, 1989). All patients were informed about the cause of symptoms and allocated to three groups: night splinting, nerve gliding and control. Evaluation consisted of Canadian Occupational Performance Measure, visual analogue pain scales, strength measurements and neurophysiological examination, before treatment and after six months. Fifty-seven patients were followed for six months. Fifty-one (89.5%) were improved at the follow-up. There were no significant differences between the groups in any of the recorded variables. Night splints and nerve gliding exercises did not add favourably. Routine neurophysiological examination seems unnecessary since 76% of the patients with typical symptoms had normal findings and 75% with pathological findings improved. Patients with mild or moderate symptoms have a good prognosis if they are informed of the causes of the condition and how to avoid provocation.

Place, publisher, year, edition, pages
2009. Vol. 34, no 2, 201-207 p.
Keyword [en]
Elbow; Nerve gliding; Neuropathy; Splinting; Ulnar nerve
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-18739DOI: 10.1177/1753193408098480OAI: oai:DiVA.org:liu-18739DiVA: diva2:221271
Available from: 2009-06-03 Created: 2009-06-03 Last updated: 2011-12-05Bibliographically approved
In thesis
1. Treatment of Epicondylalgia and Nerve Entrapments around the Elbow
Open this publication in new window or tab >>Treatment of Epicondylalgia and Nerve Entrapments around the Elbow
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Disorders causing pain in the elbow region is a common problem and is one of the most frequent forms of work-related health problems. These conditions are thus of major importance from the public health point of view, as well as from that of the suffering individual. Both sensory and motor function may be impaired, particularly in cases where a nerve is involved, resulting in severely impaired hand function.

“Tennis elbow” (lateral epicondylalgia) has been found to be the second most frequently diagnosed musculoskeletal disorder of the upper extremity in the primary health-care setting. “Golfer’s elbow” (medial epicondylalgia) is not that commonly encountered. It has been stated that tennis or golfer’s elbow syndromes are self-limiting. Even so, clinical experience has shown that there are a few cases where symptoms have a painful and long-lasting course, resistant to many forms of therapy. The outcomes of frequently adopted management regimes for treatment of epicondylalgia or nerve entrapments around the elbow were examined in the following five studies:

I: A randomised, prospective study of 38 patients with tennis elbow (lateral epicondylalgia). Groups were assigned to eccentric exercises or stretching. Eccentric exercise gave somewhat better results.In a second part of the study, a 4-year follow-up of 127 patients who used eccentric exercises for tennis elbow was performed. Patients showed decreased pain and increased grip-strength after 3 months treatment. At the time of publication this study was the first to examine eccentric exercises for this condition.

II: A retrospective analysis of long-term results from 51 patients treated with surgical release of the common extensor origin because of “chronic tennis elbow”. Eighty-seven per cent of the patients rated themselves as completely recovered or improved.

III: A randomised, prospective study of 70 patients with ulnar neuropathy in the forearm (cubital tunnel syndrome). Groups assigned the commonly recommended elbow brace at night or nerve gliding exercises were compared with a control group (information only). The majority of patients improved considerably, both subjectively and objectively, after a 3 months period, regardless of group. The study thus showed the effectiveness of information and expectance, and that orthosis or nerve gliding exercises added nothing further to the result.

IV: A retrospective study of 205 patients treated with surgery for suspected nerve entrapment in the forearm. Followup, almost 4 years later, demonstrated a subjective improvement in two of three patients, but only 3% experienced complete relief of all symptoms.

V: A prospective long-term study on 20 patients with golfer’s elbow (medial epicondylalgia) treated with eccentric exercises over 3 months. The results showed decreased pain and increased gripstrength. This is the first study published on the management of this disorder with eccentric exercises.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2012. 93 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1262
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-72719 (URN)978-91-7393-065-9 (ISBN)
Public defence
2012-01-28, Ekensalen, Campus US, Linköpings universitet, Linköping, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2011-12-05 Created: 2011-12-05 Last updated: 2011-12-16Bibliographically approved

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Adolfsson, Lars

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Plastic Surgery, Hand Surgery and BurnsFaculty of Health SciencesDepartment of Plastic Surgery, Hand surgery UHLÖstergötlands Läns LandstingOrthopaedics and Sports MedicineDepartment of Orthopaedics Linköping
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