Research methodology to assess surgery for ulnar neuropathy at the elbow

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Project Summary/Abstract: Ulnar neuropathy at the elbow (UNE) is the second most common compression neuropathy after carpal tunnel syndrome. It is three times more frequent in men than women with 73,000 new cases diagnosed in the United States each year. UNE disproportionately affects working individuals, particularly in tasks requiring prolonged or frequent flexion of the elbow. Numbness and tingling of the ring and little fingers, pain at the elbow, and loss of sensation over the arm, hand and ring fingers are the characteristic symptoms of UNE. Severe cases can also have motor deficit of the hand muscles. Diagnosis is based on signs, symptoms and electrodiagnostic studies. The most common surgical treatments for UNE are in-situ (simple) decompression of the ulnar nerve at the elbow or subcutaneous anterior nerve transposition. Choice of surgical technique differs among surgeons and there is no clear evidence regarding which procedure is more effective and for which type of patient. The parent grant for this supplement, the Surgery of the Ulnar Nerve (SUN) study (1U01AR073485) is a randomized double-blind superiority clinical trial to compare the effectiveness of in-situ decompression and subcutaneous anterior transposition by assessing patient-reported and physiologic outcomes. This supplement proposes to provide an exceptional medical student (with master’s training) with hands-on-training and skills necessary for her to pursue an academic career. Specifically, the learning and guidance she will gain from this experience will enable her to assist in investigating associations between electrodiagnostic parameters, racial/ethnic variations, and treatment outcomes related to ulnar neuropathy. Additionally, this supplement will contribute to literature on the above-mentioned topics and advance the understanding of these factors in UNE treatment.