Anterior intramuscular transposition of the ulnar nerve for cubital tunnel syndrome

Abstract

Forty-five sequential cubital tunnel releases with anterior transposition of the ulnar nerve in an intramuscular fashion were performed over a 4-year period. All patients had a positive Tinel's sign at the cubital tunnel and reported numbness and tingling in the ring and small finger of the affected arm. Thirty-three cases had preoperative electrodiagnostic studies performed. Twenty-three cases had positive electromyographic and nerve conduction velocity findings for cubital tunnel syndrome, whereas 10 cases had normal electromyographic and nerve conduction velocity studies. Twenty-four cases were covered by Workers' Compensation insurance. The average age of the patients was 40 years, with an average duration of symptoms of 22 weeks. Average follow-up examination was 15 months, with all patients being reexamined and completing a symptom outcome questionnaire. No significant differences between preoperative electrodiagnostic status could be demonstrated with regard to final symptom outcome. Patients with improved results from a symptom status were younger and had cubital tunnel syndrome of shorter duration. A trend toward poor results in patients with Workers' Compensation was noted, although this was not statistically significant. Overall, 87% of the patients had resolved or improved symptoms after cubital tunnel release with the anterior intramuscular transposition technique.