The Association Between Concomitant Ulnar Nerve Compression at the Elbow and Carpal Tunnel Syndrome

Abstract

Background: Many patients treated for ulnar nerve compression at the elbow (UNE) are concomitantly treated for carpal tunnel syndrome (CTS). We sought to investigate the association between the conditions. Methods: The Statewide Planning and Research Cooperative System (SPARCS) database was used to determine the number of patients with UNE concomitantly treated for CTS in New York State from 2003 to 2014. We then retrospectively reviewed each patient who received surgical treatment for UNE (n = 222 patients) or CTS (n = 1063 patients) at our tertiary care institution in 2014 and 2015 to assess concomitant treatment. Results: In the SPARCS database, the percentage of patients surgically treated for concomitant UNE and CTS steadily increased from 23% in 2003 to 45% in 2014. At our institution, 50 of 222 patients (23%) surgically treated for UNE underwent concomitant carpal tunnel releases. For concomitantly treated patients, 94% had examinations consistent with UNE and CTS, 87% of patients had median nerve compression on electrodiagnostic tests, and 72% of patients had UNE on electrodiagnostic tests. Conclusions: Most patients concomitantly treated for UNE and CTS have objective findings of both conditions. At least one-fourth of patients indicated for operative ulnar nerve release also require a carpal tunnel release—far beyond the prevalence of CTS in the general population. A diagnosis of UNE merits a comprehensive workup by the treating surgeon and a high suspicion for concomitant median nerve compression.