Anterior subcutaneous transposition of the ulnar nerve improves neurological function in patients with cubital tunnel syndrome

• Published in: Neural regeneration research Vol. 10; no. 10; pp. 1690 - 1695
• Main Authors: Huang, Wei, Zhang, Pei-Xun, Peng, Zhang, Xue, Feng, Wang, Tian-Bing, Jiang, Bao-Guo
• Format: Journal Article
• Language: English
• Published: India Medknow Publications and Media Pvt. Ltd 01-10-2015; Medknow Publications & Media Pvt. Ltd; Department of Trauma and Orthopedics,Peking University People's Hospital,Beijing,China; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Atrophy; Care and treatment; Elbow; Electrodes; nerve regeneration; peripheral nerve injury; ulnar nerve compression syndrome; age; motor nerve conduction velocity; electrophysiology; sensory nerve conduction velocity; modified McGowan scale; Wilson & Krout criteria; anterior transposition; ulnar nerve; NSFC grant; neural regeneration; Nervous system diseases; Pain; Patients; Special Issue; Studies; Surgery; Surgical outcomes; Wilson; 尺神经; 患者; 治疗效果; 神经功能; 综合征; 肘管; 转位; China; United States > US; ulnar nerve compression syndrome; Wilson & Krout criteria; ulnar nerve; modified McGowan scale; anterior transposition; sensory nerve conduction velocity; neural regeneration; electrophysiology; nerve regeneration; peripheral nerve injury; motor nerve conduction velocity; NSFC grant; age; NSFC gran
• ISSN: 1673-5374; 1876-7958
• DOI: 10.4103/1673-5374.167770

Although several surgical procedures exist for treating cubital tunnel syndrome, the best surgical option remains controversial. To evaluate the efficacy of anterior subcutaneous transposition of the ulnar nerve in patients with moderate to severe cubital tunnel syndrome and to analyze prognostic factors, we retrospectively reviewed 62 patients（65 elbows） diagnosed with cubital tunnel syndrome who underwent anterior subcutaneous transposition. Preoperatively, the initial severity of the disease was evaluated using the Mc Gowan scale as modified by Goldberg： 18 patients（28%） had grade IIA neuropathy, 20（31%） had grade IIB, and 27（42%） had grade III. Postoperatively, according to the Wilson ＆ Krout criteria, treatment outcomes were excellent in 38 patients（58%）, good in 16（25%）, fair in 7（11%）, and poor in 4（6%）, with an excellent and good rate of 83%. A negative correlation was found between the preoperative Mc Gowan grade and the postoperative Wilson ＆ Krout score. The patients having fair and poor treatment outcomes had more advanced age, lower nerve conduction velocity, and lower action potential amplitude compared with those having excellent and good treatment outcomes. These results suggest that anterior subcutaneous transposition of the ulnar nerve is effective and safe for the treatment of moderate to severe cubital tunnel syndrome, and initial severity, advancing age, and electrophysiological parameters can affect treatment outcome.