Return to sporting activity after ulnar nerve transposition for isolated neuritis in competitive overhead athletes

Gregory P. Nicholson, Allison J. Rao, Amanda J. Naylor, Brian R. Waterman, Michael C. O'Brien, Anthony A. Romeo, Mark S. Cohen

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Although ulnar neuritis can occur secondary to ulnar collateral ligament pathology, stress fractures, and traction apophysitis, isolated ulnar nerve dysfunction can lead to medial elbow pain. The purpose of this study was to evaluate the short-term outcomes of overhead athletes undergoing anterior ulnar nerve transposition for ulnar neuropathy. Methods: All overhead athletes who underwent isolated ulnar nerve transposition between 2009 and 2016 for refractory ulnar neuritis were identified. The primary outcome was return to sport, and secondary outcome measures included the Kerlan-Jobe Orthopaedic Clinic score; Mayo Elbow Performance Score; Quick Disabilities of the Arm, Shoulder and Hand score; Single Assessment Numeric Evaluation score; and visual analog scale score for pain. Complication and reoperation rates were recorded. Results: A total of 26 overhead athletes (21 male and 5 female athletes) underwent ulnar nerve transposition at an average age of 18.4 years (range, 11-25 years). Of the patients, 24 (92%) returned to their sporting activity at an average of 2.7 months postoperatively, including 16 (62%) at the previous level of play. The average visual analog scale pain score improved from 4.7 (±2.5) to 0.4 (±1.5) (P =.015). The average postoperative patient-reported outcome scores were as follows: Kerlan-Jobe Orthopaedic Clinic score, 80 (95% confidence interval [CI], 72.7-87.0); Single Assessment Numeric Evaluation score, 85 (95% CI, 75.4-94.7); Quick Disabilities of the Arm, Shoulder and Hand score, 5 (95% CI, 2.1-7.7); and Mayo Elbow Performance Score, 91 (95% CI, 86.8-96.0). Conclusion: Cubital tunnel syndrome can cause medial elbow pain in overhead athletes in the presence of a normal ulnar collateral ligament. At mid-term follow-up, 92% of overhead athletes returned to sport after ulnar nerve transposition, with 62% resuming their previous level of performance.

Original languageEnglish (US)
Pages (from-to)1401-1405
Number of pages5
JournalJournal of Shoulder and Elbow Surgery
Volume29
Issue number7
DOIs
StatePublished - Jul 2020
Externally publishedYes

Bibliographical note

Funding Information:
This study was supported by departmental funding.

Funding Information:
Gregory P. Nicholson receives royalties from Wright Medical Technology, Inc., Innomed, and Arthrosurface; is a paid consultant for Wright Medical Technology, Inc.; receives research support from Arthrex, Inc. and Wright Medical Inc., receives fellowship education support from Wright Medical Inc., and Smith & Nephew, is a paid presenter for Arthrosurface, and serves on the board of American Shoulder and Elbow Surgeons.

Publisher Copyright:
© 2020 Journal of Shoulder and Elbow Surgery Board of Trustees

Keywords

  • athletic injuries
  • Case Series
  • elbow
  • Level IV
  • nerve
  • Peripheral nerve injuries
  • Treatment Study
  • ulnar
  • upper extremity

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