A prospective study of predictors of return to work after surgery for ulnar nerve entrapment

Ulnar nerve entrapment at the elbow (UNE) is the second most common compression neuropathy in the upper limb. Immediate return-to-work (RTW) after surgery is seldom possible due to restrictions and recovery demands. We aimed to explore RTW after UNE surgery and investigate factors contributing to variations. A prospective study with patients undergoing primary UNE surgery was conducted. Treatment decisions were based on a novel five-grade clinical scale. In total, 65 patients (25 women and 40 men) with a mean age of 51 ± 16 years were included. Simple decompression was the predominant procedure (n = 57, 88%). Manual laborers (n = 28, 43%) had the longest sick leave (7 weeks, IQR [3]) within the working population (n = 49) compared to non-manual laborers (4 weeks, IQR [6]; p = 0.003). Manual labor, smoking, and preoperative pain (evaluated with the Swedish version of the Patient-Rated Ulnar Nerve Evaluation, PRUNE-S) predicted prolonged sick leave. The type of surgery did not predict RTW variations in the multivariate linear model itself but modified the impact of other predictors. In conclusion, patients with surgically treated UNE have varying sick leave needs, influenced by individual and work-related factors. Incorporating biopsychosocial aspects should be a focus of further research in UNE management.