Clinical Characteristics of Concomitant Versus Isolated Carpal and Cubital Tunnel Syndromes: A Prospective Cohort Study
Hand · 13 Aug 2026
† Impact is the editorial-priority score. All scores are out of 100. Clinical is a stored clinical-importance score from the earlier method; it has not been recalculated.
Why it matters
Hand surgeons should have a lower threshold to examine for dual median/ulnar nerve compression when a patient presents with objective intrinsic motor weakness rather than isolated sensory complaints.
The evidence
This prospective cohort study compared 86 surgical patients with isolated carpal tunnel syndrome (CTS), isolated cubital tunnel syndrome (CuTS), or both conditions together to see if concomitant disease is a distinct, more severe entity. Sensory symptoms and provocative tests were similar across groups, but patients with concomitant disease had significantly weaker intrinsic hand muscles (abductor pollicis brevis strength P=.0308 vs isolated CTS; abductor digiti minimi strength P=.0319 vs isolated CuTS), and concomitant disease independently predicted lower APB strength on multivariable analysis (adjusted OR 3.55, 95% CI 1.02-12.38, P=.0471), though the analogous ADM finding did not reach significance (adjusted OR 2.45, P=.1550).
Decreased abductor pollicis brevis (APB) muscle strength: Odds ratio 3.55 (95% CI 1.02 to 12.38; MRC grading). Interpret in the study's stated comparison; this alone does not establish a treatment's causal effect.
Why this rigour score?
Prospective cohort
Methods at a glance
Recorded assessment- Confounding adjustmentMultivariable regression
- Covariate balance confirmedNot reported
- Outcome assessors blindedNot reported
- Comparable start of follow-upNot applicable
- Adequate statistical powerCalculation absent
- Prospective registrationNot reported
Not reported does not mean not done. Checks have different weights; this is not a count of boxes ticked.
How to read this assessment
The recorded methods are shown alongside the published score. A verified point-by-point calculation is not available for this version of the appraisal.
Checklist from the stored appraisal. “Not met” describes the recorded criterion; it does not always produce a deduction. This overview supports reading the full study.
For journal club
1.Should the finding of intrinsic muscle weakness on exam prompt routine screening for the 'other' nerve (median or ulnar) before proceeding to single-site decompression?
2.How might identifying concomitant CTS/CuTS preoperatively change surgical planning or patient counselling about expected recovery after decompression?
Original publication title
Clinical Characteristics of Concomitant Versus Isolated Carpal and Cubital Tunnel Syndromes: A Prospective Cohort Study