Zlowodzki cubital tunnel meta-analysis

Anterior transposition compared with simple decompression for treatment of cubital tunnel syndrome. A meta-analysis of randomized, controlled trials.

Zlowodzki M, Chan S, Bhandari M, et al. The Journal of bone and joint surgery. American volume 2007 · PMID 18056489 · doi:10.2106/jbjs.g.00183

Question

Does anterior transposition of the ulnar nerve give better results than simple decompression for cubital tunnel syndrome?

Design

Meta-analysis of randomised controlled trials.

Patients

Adults with cubital tunnel syndrome without prior elbow surgery or trauma.

Intervention

Anterior transposition (subcutaneous or submuscular)

Comparison

Simple decompression

Primary outcome

Clinical outcome scores and postoperative nerve conduction velocity

Key result

There was no significant difference in clinical scores or nerve conduction between transposition and simple decompression.

Limitations

Few small trials with differing outcome measures.

Impact on practice

Together with the individual RCTs, made in situ decompression the default procedure, as it is simpler with fewer complications and equivalent results.