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Journal of Hand Surgery (European Volume)
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The Surgical Treatment of Cubital Tunnel Syndrome: A Decision Analysis

C. A. BRAUER
B. GRAHAM

From the Harvard Center for Risk Analysis, Harvard School of Public Health, Boston, MA, USA and the University of Toronto, University Health Network, Toronto, Ont., Canada

Correspondence: Dr Brent Graham, Toronto Western Hospital, 399 Bathurst Street, Toronto, Ont., Canada M5T 2S8. Tel.: +1 416 603 5647; fax: +1 416 603 5716. E-mail:Brent.Graham{at}uhn.on.ca

The objective of our study was to use decision analysis to compare four common surgical treatments for cubital tunnel syndrome: simple decompression of the cubital tunnel, medial epicondylectomy, anterior subcutaneous transposition and anterior submuscular transposition. The variables used for this decision analysis model were based on data from the literature. Extensive sensitivity analyses were carried out to test the impact of the values given to these variables on the outcome of the model. The highest expected utility, 0.973, was associated with simple decompression. The expected utility was 0.969 for subcutaneous transposition and 0.965 for submuscular transposition. Medial epicondylectomy had the lowest expected utility at 0.961. Simple decompression remained the preferred strategy in extensive one-way sensitivity analyses.

Key Words: cubital tunnel syndrome • decision analysis • utility • nerve compression • ulnar nerve

Journal of Hand Surgery (European Volume), Vol. 32, No. 6, 654-662 (2007)
DOI: 10.1016/J.JHSE.2007.07.001
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