RESEARCH—HUMAN—CLINICAL TRIALS
Power, Hollie A MD, FRCSC; Morhart, Michael J MD, MSc, FRCSC; Olson, Jaret L MD, FRCSC; Chan, K Ming MD, FRCPC
Division of Plastic Surgery, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
Division of Physical Medicine and Rehabilitation, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
Correspondence: K. Ming Chan, MD, PRCPC, Division of Physical Medicine and Rehabilitation, Faculty of Medicine and Dentistry, 5005 Katz Group Centre, University of Alberta, Edmonton, Canada T6G 2E1. Email: [email protected]
Abstract Associated Multimedia
BACKGROUND
Patients with severe cubital tunnel syndrome often have poor functional recovery with conventional surgical treatment. Postsurgical electrical stimulation (PES) has been shown to enhance axonal regeneration in animal and human studies.
OBJECTIVE
To determine if PES following surgery for severe cubital tunnel syndrome would result in better outcomes compared to surgery alone.
METHODS
Patients with severe cubital tunnel syndrome in this randomized, double-blind, placebo-controlled trial were randomized in a 1:2 ratio to the control or stimulation groups. Control patients received cubital tunnel surgery and sham stimulation, whereas patients in the stimulation group received 1-h of 20 Hz PES following surgery. Patients were assessed by a blinded evaluator annually for 3 yr. The primary outcome was motor unit number estimation (MUNE) and secondary outcomes were grip and key pinch strength and McGowan grade and compound muscle action potential.
RESULTS
A total of 31 patients were enrolled: 11 received surgery alone and 20 received surgery and PES. Three years following surgery, MUNE was significantly higher in the PES group (176 ± 23, mean + SE) compared to controls (88 ± 11, P < .05). The mean gain in key pinch strength in the PES group was almost 3 times greater than in the controls (P < .05). Similarly, other functional and physiological outcomes showed significantly greater improvements in the PES group.
CONCLUSION
PES enhanced muscle reinnervation and functional recovery following surgery for severe cubital tunnel syndrome. It may be a clinically useful adjunct to surgery for severe ulnar neuropathy, in which functional recovery with conventional treatment is often suboptimal.
Graphical Abstract
