A Cochrane review [Abstract] 1 included 9 studies with a total of 587 subjects. No difference was found between simple decompression and transposition of the ulnar nerve for both clinical improvement (risk ratio (RR) 0.93, 95% confidence interval (CI) 0.80 to 1.08) and neurophysiological improvement (mean difference (in m/s) 1.47, 95% CI -0.94 to 3.87). The number of participants to clinically improve was 91 out of 131 in the simple decompression group and 97 out of 130 in the transposition group. Transposition showed a higher number of wound infections (RR 0.32, 95% CI 0.12 to 0.85).
One RCT (n=51) compared different conservative approaches to treat clinically mild or moderate ulnar neuropathy. Provision of information on avoiding prolonged movements or positions was effective in improving subjective discomfort. Night splinting and nerve gliding exercises in addition to the information did not produce further improvement.
One trial (55 participants) assessed the effectiveness of corticosteroid injection and found no difference versus placebo in improving symptoms at three months' follow-up.
Comment: The quality of evidence is downgraded by indirectness (few comparisons between surgical and conservative treatments).
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