Vascularized anterior subcutaneous transposition of the ulnar nerve with inferior ulnar collateral artery for treatment of severe cubital tunnel syndrome through minimal incision in elbow

Abstract

Objective To investigate the surgical method and clinical efficacy of vascularized anterior subcutaneous transposition of the ulnar nerve with inferior ulnar collateral artery for treatment of severe cubital tunnel syndrome through minimal incision in the medial elbow. Methods From June 2015 to June 2017, 22 patients with severe cubital tunnel syndrome were admitted and divided into two groups according to different surgical methods: the vascularized anterior subcutaneous transposition of the ulnar nerve and the vascularized anterior subcutaneous transposition of the ulnar nerve through minimal incision in elbow. The conduction velocity of ulnar nerve through elbow joint, the two-point discrimination of the distal pulp of the little finger and the length of incision were compared between the two groups. Results All the 22 patients were follow-up for 8 to 15 months, with an average of 12.2 months. The excellent and good rate was 82.29% in the vascularized anterior subcutaneous transposition of the ulnar nerve group and 80.91% in the group with minimal incision in elbow. There was no significant difference between the two groups in the changes of ulnar nerve conduction velocity before and after the operation and in the recovery of two-point discrimination of the distal pulp of the little finger. After using the minimal incision in elbow, the average conventional incision of 13.4 cm was reduced to 4.7 cm. Conclusion The vascularized anterior subcutaneous transposition of the ulnar nerve operation ensures the blood supply of the local ulnar nerve of the elbow. It is a kind of operation method for the treatment of severe cubital tunnel syndrome. On this basis, the selection of the minimal incision on the medial side of the elbow can also achieve the clinical efficacy of the conventional incision length. The minimal incision can recover more quickly and the appearance of operation area is better. Key words: Cubital tunnel syndrome; Treatment outcome; Severe; Inferior ulnar collateral artery