Treatment for ulnar neuropathy at the elbow.
Caliandro P, La Torre G, Padua R, et al. The Cochrane database of systematic reviews 2016 · PMID 27845501 · doi:10.1002/14651858.cd006839.pub4
- Question
- Which conservative and surgical treatments are effective for ulnar neuropathy at the elbow?
- Design
- Cochrane systematic review and meta-analysis of randomised and quasi-randomised trials.
- Patients
- People with clinical features of ulnar neuropathy at the elbow, with or without neurophysiological confirmation.
- Intervention
- Surgical options (decompression, transposition, medial epicondylectomy, endoscopic release) and conservative care (splinting, information, injection)
- Comparison
- Each other or no specific treatment
- Primary outcome
- Clinical improvement at follow-up
- Key result
- Simple decompression and transposition gave similar clinical improvement, with more wound complications after transposition; evidence comparing endoscopic with open release and for conservative measures was of low quality, although advice on avoiding prolonged elbow flexion and pressure may help mild cases.
- Limitations
- Small number of trials with low-quality evidence for most comparisons.
- Impact on practice
- Supports advice and activity modification for mild symptoms, with simple decompression as the usual operation when surgery is needed.