Splinting and local steroid injection for the treatment of ulnar neuropathy at the elbow: clinical and electrophysiological evaluation.

Abstract

OBJECTIVE:

To compare the effects of splinting alone in the treatment of ulnar nerve lesion at the elbow with the effects of applying a local steroid injection in addition to splinting.

DESIGN:

Twelve nerves of 10 patients were randomly assigned into two groups: 5 nerves in Group A were treated with elbow splinting only; 7 nerves in Group B were treated with local steroid injection in addition to splinting. Therapeutic effects were assessed 1 and 6 months after treatment.

SETTING:

Patients were selected from an outpatient clinic of a VA Medical Center.

PATIENTS:

Ten patients (12 nerves) with ulnar neuropathy at the elbow confirmed by electrodiagnostic tests.

INTERVENTIONS:

Elbow splint was given to patients of both Groups A and B. A single dose of 40 mg triamcinolone plus 1 mL of 1% lidocaine was injected around the ulnar nerve at the elbow of Group A patients.

MAIN OUTCOME MEASURES:

Clinical evaluation of symptoms and signs, and ulnar motor and sensory nerve conduction studies were performed before, 1 month after, and 6 months after treatment.

RESULTS:

There was significant improvement in symptoms in both groups at 1 and 6 months after treatment. Ulnar motor nerve conduction velocity across the elbow improved at 1 month in Group A only, but showed improvement at 6 months in both groups. There was no significant change in the other parameters either at 1 or 6 months in both groups. In comparing the differences between Groups A and B regarding the changes at 1 or 6 months after treatment, there was no significant difference between the two groups in all parameters.

CONCLUSIONS:

Splint application alone is adequate to improve the symptoms and ulnar nerve conduction across the elbow. The addition of a steroid injection did not provide further benefit in the treatment of cubital tunnel syndrome.

• Authors: C Z Hong, H A Long, R V Kanakamedala, Y M Chang, L Yates
• Journal: Archives of physical medicine and rehabilitation (Arch Phys Med Rehabil) Vol. 77 Issue 6 Pg. 573-7 (Jun 1996) ISSN: 0003-9993 [Print] United States
• PMID: 8831474 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Inflammatory Agents
• Triamcinolone

Topics

• Adult
• Aged
• Anti-Inflammatory Agents (therapeutic use)
• Humans
• Middle Aged
• Nerve Compression Syndromes (drug therapy, physiopathology, therapy)
• Neural Conduction
• Outcome Assessment, Health Care
• Splints
• Time Factors
• Triamcinolone (administration & dosage, therapeutic use)
• Ulnar Nerve (physiopathology)