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Cubital Tunnel SyndromeNCT02466841

Prospective Comparison of Techniques for Cubital Tunnel Release

An observational study of Cubital Tunnel Syndrome, run by University of Pittsburgh.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

Compression of the ulnar nerve at the elbow (cubital tunnel syndrome) is the second most common compressive neuropathy of the upper extremity (carpal tunnel is the most common). Patients who fail conservative treatment (activity modification, splinting, medications) are offered cubital tunnel release. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Cubital Tunnel Syndrome
What is being tested?
Cubital tunnel release
Type of treatment
Surgery or procedure
How many people
0 participants
Where
No sites listed yet
Study dates
Aug 2015to 1 Nov 2019
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Patients undergoing cubital tunnel release

Who may be able to join

  • patients indicated to surgery by attending surgeon

Who cannot join

  • previous cubital tunnel release on ipsilateral side
  • unable/unwilling to provide consent
  • pregnant women
  • prisoners
  • < 18 years of age

About this study

Compression of the ulnar nerve at the elbow (cubital tunnel syndrome) is the second most common compressive neuropathy of the upper extremity (carpal tunnel is the most common). Patients who fail conservative treatment (activity modification, splinting, medications) are offered cubital tunnel release. There are multiple techniques to decompress the ulnar nerve at the elbow, but the ideal release has not been determined. These techniques vary from simple decompression of the nerve (in-situ release, endoscopic release), to decompressing the nerve and moving it anteriorly to take tension off the nerve (subcutaneous transposition, sub-fascial transposition, sub muscular transposition), and removing part of the medial epicondyle (medial epicondylectomy). Each procedure has purported benefits and also potential complications. Simple in-situ release has the benefit of shorter operative times and less surgical dissection, however, the nerve may subluxate post-operatively and cause persistent pain. Procedures to move the nerve (subcutaneous transposition, sub-fascial transposition, sub muscular transposition) prevent subluxation and take tension off the nerve, however, they require more dissection, larger incisions, and also partially devascularize the nerve. Medial epicondylectomy prevents subluxation and decompresses the nerve, but some patients may have a prolonged recovery and persistent pain from removing part of the bone.

The purpose of this study is to prospective evaluate patients undergoing cubital tunnel release according to the standard practice and preference of their surgeon. The investigators plan to compare the different techniques at standard post-operative intervals.

Read the detailed description

Objective:

The purpose of this study is to compare different techniques for cubital tunnel release.

Specific Aims:

  1. Determine if there are differences in patient-directed outcomes scores between different techniques used for cubital tunnel release.
  2. Determine if there are differences in post-operative pain scores between different techniques used for cubital tunnel release.
  3. Determine if there are differences in objective measurements such as range of motion and grip strength scores between different techniques used for cubital tunnel release.
  4. Determine if there are differences in complications between different techniques used for cubital tunnel release.

Background:

Compression of the ulnar nerve at the elbow (cubital tunnel syndrome) is the second most common compressive neuropathy of the upper extremity (carpal tunnel is the most common). Patients who fail conservative treatment (activity modification, splinting, medications) are offered cubital tunnel release. There are multiple techniques to decompress the ulnar nerve at the elbow, but the ideal release has not been determined. These techniques vary from simple decompression of the nerve (in-situ release, endoscopic release), to decompressing the nerve and moving it anteriorly to take tension off the nerve (subcutaneous transposition, sub-fascial transposition, sub muscular transposition), and removing part of the medial epicondyle (medial epicondylectomy). Each procedure has purported benefits and also potential complications. Simple in-situ release has the benefit of shorter operative times and less surgical dissection, however, the nerve may subluxate post-operatively and cause persistent pain. Procedures to move the nerve (subcutaneous transposition, sub-fascial transposition, sub muscular transposition) prevent subluxation and take tension off the nerve, however, they require more dissection, larger incisions, and also partially devascularize the nerve. Medial epicondylectomy prevents subluxation and decompresses the nerve, but some patients may have a prolonged recovery and persistent pain from removing part of the bone.

Significance:

The results of this study may provide a high level of evidence to determine if specific techniques for cubital tunnel decompression result in improved patient outcomes and/or fewer complications.

Being tested
Cubital tunnel release
Medical subject headings
Cubital Tunnel Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Cubital tunnel releaseProcedure or surgery

    Patients undergoing cubital tunnel release for ulnar nerve compression at elbow

Study groups in NCT02466841
Study groupRoleWhat they receive
Patients undergoing cubital tunnel release surgeryPatients undergoing cubital tunnel release surgery will be enrolled. All enrolled subjects will be followed regardless of the technique used by surgeon.
Receives: Procedure: Cubital tunnel release

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Patient rated ulnar nerve evaluation (PRUNE) score

    The PRUNE is a validated patient rated outcome measurement to assess pain, symptoms and functional disability in patients with ulnar nerve compression at the elbow.

    Measured: 1 year

Secondary outcomes (5)
  1. Elbow Range of Motion

    The elbow range of motion will be measured in degrees.

    Measured: 1 year

  2. Visual Analog Scale (VAS) for Pain

    The VAS for pain is a patient-reported single-item scale with scores ranging 0 (no pain) to 10 (worst pain).

    Measured: 1 year

  3. 2 Point Discrimination Test

    The test will measure, in millimeters, the ability of a patient to determine discern the difference between two points when 2 separate instruments are touched to the skin.

    Measured: 1 year

  4. Hand Dynamometer to measure Grip Strength

    The Hand Dynamometer is a simple hand-held device when squeezed, will report grip strength in kgs.

    Measured: 1 year

  5. Number of subjects with post-surgical complications

    The presence or absence of post-surgical complications will be recorded for each subject.

    Measured: 1 year

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 Jun 2015 (estimated)
  2. Study startAug 2015
  3. Primary completion1 Nov 2019
  4. Study completion1 Nov 2019

Why it stopped: Could not get any patients to sign up

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02466841
Sponsor's protocol ID
PRO15040063
Status last verified
Apr 2023
First submitted
3 Jun 2015
Last updated
13 Apr 2023
Results posted
No
Data monitoring committee
Yes

Publications

  • Palmer BA, Hughes TB. Cubital tunnel syndrome. J Hand Surg Am. 2010 Jan;35(1):153-63. doi: 10.1016/j.jhsa.2009.11.004.

    PubMed 20117320
  • Osei DA, Padegimas EM, Calfee RP, Gelberman RH. Outcomes following modified oblique medial epicondylectomy for treatment of cubital tunnel syndrome. J Hand Surg Am. 2013 Feb;38(2):336-43. doi: 10.1016/j.jhsa.2012.11.006. Epub 2013 Jan 3.

    PubMed 23291082
  • MacDermid JC, Grewal R. Development and validation of the patient-rated ulnar nerve evaluation. BMC Musculoskelet Disord. 2013 Apr 26;14:146. doi: 10.1186/1471-2474-14-146.

    PubMed 23617407

Questions about this trial

What is this clinical trial studying?

An observational study of Cubital Tunnel Syndrome, run by University of Pittsburgh.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: withdrawn, as of the sponsor's last update on 13 Apr 2023. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Patient rated ulnar nerve evaluation (PRUNE) score (time frame: 1 year). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02466841, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Apr 2023.

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