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CC BY-NC-ND 4.0 · Arch Plast Surg 2023; 50(01): 070-081
DOI: 10.1055/s-0042-1757571
Hand/Peripheral Nerve
Original Article

Conservative Treatment of Ulnar Nerve Compression at the Elbow: A Systematic Review and Meta-Analysis

Tinatin Natroshvili 
1   Department of Plastic and Reconstructive Surgery, CWZ, Nijmegen, The Netherlands
2   Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
3   Department of Plastic and Reconstructive Surgery, Martini Hospital, Groningen, The Netherlands
,
Milly S. van de Warenburg 
1   Department of Plastic and Reconstructive Surgery, CWZ, Nijmegen, The Netherlands
2   Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
,
Erwin P. Heine 
1   Department of Plastic and Reconstructive Surgery, CWZ, Nijmegen, The Netherlands
,
Nicholas J. Slater 
1   Department of Plastic and Reconstructive Surgery, CWZ, Nijmegen, The Netherlands
2   Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
,
Erik T. Walbeehm 
2   Department of Plastic and Reconstructive Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
,
Ronald H. M. A. Bartels 
4   Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands
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Abstract

Background The clinical results of conservative treatment options for ulnar compression at the elbow have not been clearly determined. The aim of this review was to evaluate available conservative treatment options and their effectiveness for ulnar nerve compression at the elbow.

Methods In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, a systematic review and meta-analysis of studies was performed. Literature search was performed using Ovid MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL).

Results Of the 1,079 retrieved studies, 20 were eligible for analysis and included 687 cases of ulnar neuropathy at the elbow. Improvement of symptoms was reported in 54% of the cases receiving a steroid/lidocaine injection (95% confidence interval [CI], 41–67) and in 89% of the cases using a splint device (95% CI, 69–99).

Conclusions Conservative management seems to be effective. Both lidocaine/steroid injections and splint devices gave a statistically significant improvement of symptoms and are suitable options for patients who refuse an operative procedure or need a bridge to their surgery. Splinting is preferred over injections, as it shows a higher rate of improvement.

Keywords

ulnar nerve compression syndromes - nerve compression syndromes - conservative treatment

Note

The authors received no financial support for the research, authorship, and/or publication of this article.


Authors' Contributions

T.N.: conceptualization, data curation, formal analysis, investigation, methodology, writing – original draft, writing – review and editing.


M.S.v.d.W.: Conceptualization, data curation, formal analysis, investigation, methodology, writing – original draft, writing – review and editing.


E.P.H.: Conceptualization, methodology, writing – original draft, writing – review and editing.


N.J.S.: Data curation, formal analysis, investigation, methodology, writing – original draft.


E.T.W.: Conceptualization, project administration, supervision, writing – review and editing.


R.H.M.A.B.: Conceptualization, investigation, methodology, project administration, resources, supervision, writing – review and editing.




Publication History

Received: 27 January 2022

Accepted: 26 May 2022

Article published online:
06 February 2023

© 2023. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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