Clinical efficacy of simple decompression versus anterior transposition of the ulnar nerve for the treatment of cubital tunnel syndrome: A meta-analysis

Abstract

Objectives: The aim of this study was to evaluate the clinical efficacy of simple decompression (SD) versus anterior transposition (AT) of the ulnar nerve for the treatment of cubital tunnel syndrome.

Methods: Seven public databases (PubMed, MEDLINE and EMBASE, Springer, Elsevier Science Direct, Cochrane Library and Google scholar) were searched from 1971 to December 2013. The overall odds ratios (OR) and their 95% confidence intervals (CI) were pooled to compare the clinical outcomes. Subgroup analysis was performed based on the region, study type, Jadad score, type of AT, and follow-up duration. Meta-analysis was conducted by using Rev. Man 5.1 and Stata 11.0 software.

Results: Finally, we included 13 studies involved 1009 (500 patients receiving SD and 509 patients receiving AT) patients with cubital tunnel syndrome. The overall estimate (OR=0.91, 95% CI=0.67-1.23, P=0.536) indicated that there was no significantly statistical difference between the clinical outcomes of patients treated with SD and AT. Meanwhile, subgroup analyses by region, study type, Jadad score, type of AT and follow-up duration showed the consistent results with the overall estimate. In addition, we found that the incidence of complications in patients treated by SD was significantly lower than that in patients treated by AT (OR=0.32, 95% CI=0.17-0.60, P=0.05).

Conclusions: In conclusion, although SD had equivalent clinical outcomes with AT for the treatment of cubital tunnel syndrome, SD should be preferred due to having lower incidence of complications.

Keywords: Anterior transposition; Clinical efficacy; Cubital tunnel syndrome; Meta-analysis; Simple decompression.