Anterior V-Y Submuscular Transposition of Ulnar Nerve for Compression Ulnar Neuritis (Author’s Method)

ABSTRACT

Many patients with ulnar nerve compression at the elbow have been treated by the old method of deep anterior transposition of the nerve under the muscles of the flexor origin. Although this method has provided good results in the past, a number of patients had a deep transposition, continued to experience local pain in the postoperative scar with residual paresthesias in the ulnar nerve distribution.

Eighty patients (34 women and 46 men) aged between 20 and 68 years underwent ulnar nerve compression. A medial incision made over the elbow, exposes the ulnar nerve and frees it at the ulnar groove. Neurolysis is performed if indicated. The medial intermuscular septum is excised and the nerve is mobilized proximally. The nerve branches of the ulnar nerve supplying the flexor carpi ulnaris and flexor profundi of the ring and little fingers are mobilized, dissected, and retracted. The origin of the flexor muscles are dissected and V-Y plasty is performed. Using this method, the nerve is transposed in the new created bed, the flexor muscles are lengthened 2 cm, and a wide space is created for the ulnar nerve. This space is much larger compared to the previous method.

In this study, 75% excellent and 25% good results were reported with 2- to 10-year follow-up. No fair results or failures were reported.