Neurophysiological study for Ulnar Entrapment at Wrist or across Elbow

  • Research type

    Research Study

  • Full title

    Neurophysiological grading tool of ulnar nerve entrapment at or across wrist and elbow

  • IRAS ID

    286359

  • Contact name

    Salim Hirani

  • Contact email

    salim.hirani@wales.nhs.uk

  • Sponsor organisation

    BCUHB

  • Duration of Study in the UK

    0 years, 11 months, 31 days

  • Research summary

    At present, there is no standardised grading tool for the severity of ulnar nerve entrapment across or at the wrist (UNEAW) or at the elbow followed in the United Kingdom. There are a variety of tests available to diagnose UNEAW or at elbow but it is only the nerve conduction assessment which gives the information which can use to stage the severity of entrapment of ulnar nerve. At present, there is no clear guidance from British society of Clinical Neurophysiology (BSCN) or Association of Neurophysiological sciences (ANS) to diagnose the ulnar nerve entrapment at or below wrist or across elbow which are the professional bodies in the UK for Neurophysiology.

    The aim of this research is to establish, using the best available evidence base and a clinically appropriate grading system of the current ulnar nerve entrapment across wrist (UNEAW) or entrapment across elbow (UNEAE) nerve conduction study and to compare this with the existing research papers.

    There are several grading processes to diagnose specifically UNEAW and UNEAE. Most of the grading studies are subjective. Some lack a neurophysiological focus in objectivity during the collection of the data. As objective testing is on evidence base it would be repeatable, so there is no chance of bias. Some researches only focus on First Dorsal Interosseous (FDI) or Abductor Digiti Minimi (ADM), the muscles connected with ulnar nerve and some research includes Needle examination, an EMG test which is not recommended by ANS to Clinical physiologist. Some research mention entrapment of ulnar nerve at wrist but did not include entrapment below wrist.

    In this research, we looked at all missing points and put them together in one place, so that a proper research would be in front of the reader and a proper investigation would be done to diagnose the level of entrapment.

  • REC name

    London - Fulham Research Ethics Committee

  • REC reference

    22/PR/0934

  • Date of REC Opinion

    25 Jul 2022

  • REC opinion

    Unfavourable Opinion