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. 2022 Nov;10(11):969-975.
doi: 10.22038/ABJS.2021.60743.2996.

Human Amniotic Membrane Wrapping of the Ulnar Nerve During Cubital Tunnel Surgery Reduces Recurrence of Symptoms

Raffy Mirzayan  1 , Franco Russo  2 , Su-Jau T Yang  3 , Nikko Lowe  1 , Christopher J Shean  1 , Neil G Harness  4
Affiliations

Human Amniotic Membrane Wrapping of the Ulnar Nerve During Cubital Tunnel Surgery Reduces Recurrence of Symptoms

Raffy Mirzayan et al. Arch Bone Jt Surg. 2022 Nov.

Abstract

Background: Compare the recurrence rate of paresthesias in patients undergoing primary cubital tunnel surgery in those with and without wrapping of the ulnar nerve with the human amniotic membrane (HAM).

Methods: A retrospective investigation of patients undergoing primary cubital tunnel surgery with a minimum 90-day follow-up was performed. Patients were excluded if the nerve was wrapped using another material, associated traumatic injury, simultaneous Guyon's canal release, or revision procedures. Failure was defined as those patients who experienced initial complete resolution of symptoms (paresthesias) but then developed recurrence of paresthesias.

Results: A total of 57 controls (CON) and 21 treated with HAM met our inclusion criteria. There was a difference in the mean age of CON (48.4 ± 13.5 years) and HAM (30.6 ± 15) (P< 0.0001). There was no difference in gender mix (P=0.4), the severity of symptoms (P=0.13), and length of follow-up (P=0.084). None of 21 (0%) treated with HAM developed recurrence of symptoms compared to 11 of 57 (19.3%) (P=0.03) (CON). Using a multivariate regression model adjusted for age and procedure type, CON was 24.4 (95% CI=1.26-500, P=0.0348) times higher risk than HAM of developing a recurrence of symptoms.

Conclusion: The HAM wrapping used in primary cubital tunnel surgery significantly reduced recurrence rates of paresthesias. Further prospective studies with randomization should be carried out to better understand the role HAM can play in cubital tunnel surgery.

Keywords: Amnion; Cubital tunnel; Human amniotic membrane; Nerve wrap; Ulnar nerve.

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Figures

Figure 1
Figure 1
A. Human amniotic membrane (HAM) is held next to a decompressed ulnar nerve (N), B. Ulnar nerve wrapped in HAM (N+HAM). M- medial epicondyle
See this image and copyright information in PMC

References

    1. Palmer BA, Hughes TB. Cubital tunnel syndrome. J Hand Surg Am. 2010;35(1):153–63. - PubMed
    1. Camp CL, Ryan CB, Degen RM, Dines JS, Altchek DW, Werner BC. Risk factors for revision surgery following isolated ulnar nerve release at the cubital tunnel: a study of 25,977 cases. J Shoulder Elbow Surg. 2017;26(4):710–5. - PubMed
    1. Staples JR, Calfee R. Cubital Tunnel Syndrome: Current Concepts. J Am Acad Orthop Surg. 2017;25(10):e215–e24. - PubMed
    1. Shi Q, MacDermid JC, Santaguida PL, Kyu HH. Predictors of surgical outcomes following anterior transposition of ulnar nerve for cubital tunnel syndrome: a systematic review. J Hand Surg Am. 2011;36(12):1996–2001 e1-6. - PubMed
    1. Nellans K, Tang P. Evaluation and treatment of failed ulnar nerve release at the elbow. Orthop Clin North Am. 2012;43(4):487–94. - PubMed

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