Surgical outcome for severe cubital tunnel syndrome in patients aged >70 years: a mean follow-up of 4.5 years.

BACKGROUND: Surgical outcomes for cubital tunnel syndrome have been reported to be satisfactory, but could be compromised by advanced age and severe nerve compression. We aim to evaluate the prognosis of severe cubital tunnel syndrome in patients aged >70 years.

METHODS: This retrospective study included 25 patients (26 extremities, all McGowan grade III, age >70 years); 21 underwent subcutaneous transposition and 5 in situ decompression. Postoperative follow-up lasted >2 years. Demographic data, clinical symptoms, physical examination findings, and the Disabilities of the Shoulder, Arm, and Hand Questionnaire were evaluated preoperatively and at final follow-up. Pain and weakness were evaluated using the visual analog scale and overall functional recovery using the modified Bishop's Score and McGowan Grade.

RESULTS: Significant improvements were seen in both sensory and motor function. VAS pain and weakness, 2-PD, key-pinch strength, grip strength, first dorsal interosseous muscle strength, the Wartenberg sign, and claw hand all improved significantly. DASH scores improved from an average of 45.2 points preoperatively to 15.9 points postoperatively. According to the modified Bishop scoring system, 10 extremities were graded excellent; 12, good; 2, fair; and 2, poor. Improvement of at least one McGowan Grade was seen in 18 cases, but only 2 extremities recovered to normal.

CONCLUSION: For patients aged >70 years with severe cubital tunnel syndrome, surgical treatment is effective, but complete recovery is unlikely, and the recovery process is long.