Shoulder position increases ulnar nerve strain at the elbow of patients with cubital tunnel syndrome

Kensuke Ochi, Yukio Horiuchi, Koichi Horiuchi, Takuji Iwamoto, Yasushi Morisawa, Kazuki Satou

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Background: Previous studies have shown that the shoulder internal rotation elbow flexion (SIREF) test, which is a modified elbow flexion (EF) test, has significantly higher sensitivity than the EF test in patients with cubital tunnel syndrome (CubTS). Here, we hypothesized that this increase in sensitivity was due to increase in the ulnar nerve strain around the elbow introduced by the additional shoulder position. Methods: Ulnar nerve strain at the elbow was intraoperatively measured at both the EF test and SIREF test positions in 20 patients with CubTS before simple decompression. Statistical analysis was performed with the Wilcoxon signed rank test at a confidence level of 99% (. P < .001). Results: Mean ulnar nerve strain in the EF test position was 18.9% ± 12.1%, whereas that in the SIREF test position was 24.7% ± 14.0%. Ulnar nerve strain was higher in the SIREF than in the EF test position in all cases, and the difference was significant (mean, 5.8% ± 0.9%; 95% confidence interval, 3.90%-7.73%). Conclusion: This study indicated that increased sensitivity in the SIREF test compared with the EF test was due to the increase in ulnar nerve strain around the elbow. To the best of our knowledge, this is the first study showing that shoulder position changes the ulnar nerve strain around the elbow in living patients with CubTS.

Original languageEnglish
Pages (from-to)1380-1385
Number of pages6
JournalJournal of Shoulder and Elbow Surgery
Volume24
Issue number9
DOIs
Publication statusPublished - 2015 Sep 1

Keywords

  • Basic Science Study
  • Biomechanics
  • Cubital tunnel syndrome
  • Elbow flexion test
  • Nerve strain
  • Shoulder abduction
  • Shoulder internal rotation
  • Shoulder internal rotation elbow flexion test
  • Ulnar nerve palsy
  • Ulnar neuropathy

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

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