Anterior submuscular transposition of the ulnar nerve

Bartels, Ronald H. M. A.; Grotenhuis, J. André

doi:10.1302/0301-620x.86b7.14877

Cited by 29 publications

(8 citation statements)

References 20 publications

(49 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Postoperative wound infection was encountered only in the submuscular ulnar nerve transposition and this is in agreement with that of Bartels et al . [28] who also conducted a higher infection rate among those with submuscular ulnar nerve transposition. The submuscular procedure demanded more dissection measures to provide a soft vascularized muscle bed for the nerve, with more postoperative tissue oedema and so more vulnerability for wound infection.…”

Section: Discussionmentioning

confidence: 99%

Subcutaneous vs Submuscular Ulnar Nerve Transposition in Moderate Cubital Tunnel Syndrome

Jaddue¹,

Saloo²,

Sayed-Noor³

2009

TOORTHJ

View full text Add to dashboard Cite

Background:The surgical treatment of Cubital tunnel syndrome (CubTS) is still a matter of debate. No consensus exists about the necessity of anterior transposition of the ulnar nerve after decompression. However, this technique is fairly common in clinical practice. Material and Methodology:In the present study we compared the operative technique (incision length, operative time), postoperative care (postoperative pain and complications) and the outcome between subcutaneous transposition and submuscular transposition of the ulnar nerve as two surgical modalities in treating moderate CubTS.Between March 2004 and March 2007, twenty six patients with moderate CubTS (according to Dellon’s grading system) were stratified according to age and gender into these two surgical techniques. The two groups were prospectively followed up 2 weeks, 6 months and 12 months postoperatively by the same observer and the operation outcome was assessed using the Bishop rating system.Results:We found that the subcutaneous transposition of the ulnar nerve was associated with shorter incision, shorter operative time, less postoperative pain, less postoperative complication and better outcome compared with the submuscular transposition.Conclusion:The authors recommend the subcutaneous technique when considering anterior transposition of the ulnar nerve in treating moderate CubTS.

show abstract

Section: Discussionmentioning

confidence: 99%

Subcutaneous vs Submuscular Ulnar Nerve Transposition in Moderate Cubital Tunnel Syndrome

Jaddue¹,

Saloo²,

Sayed-Noor³

2009

TOORTHJ

View full text Add to dashboard Cite

show abstract

“…14 While duration of symptoms has not been shown to affect outcomes of revision decompression, greater preoperative severity of symptoms is associated with worse outcomes. 6,[15][16][17] Generally, revision decompression has been associated with worse outcomes compared with primary nerve decompression in the upper extremities. 18 Outcomes in our cohort compare favorably to both primary and revision nerve decompression procedures.…”

Section: Discussionmentioning

confidence: 99%

Avive Soft Tissue Membrane Improves Outcomes of Revision Upper-extremity Nerve Decompression Surgery

Cox

Douthit

McKee

et al. 2023

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background: Revision nerve decompression remains a challenge for surgeons. Avive Soft Tissue Membrane is processed human umbilical cord membrane that may reduce inflammation and scarring, thereby improving tissue gliding. Although synthetic conduits have been reported in revision nerve decompression, the use of Avive has not. Methods: Prospective study of revision nerve decompression with Avive application. VAS pain, two-point discrimination, Semmes-Weinstein, pinch and grip strength, range of motion, Quick Disability of Arm, Shoulder & Hand (QuickDASH), and satisfaction were recorded. Using a propensity-matched cohort, VAS pain and satisfaction were retrospectively collected to compare with cohort outcomes. Results: In the Avive cohort, 77 patients (97 nerves) were included. Mean followup was 9.0 months. Avive was applied to the median nerve in 47.4%, ulnar nerve in 39.2%, and radial nerve in 13.4%. VAS pain was 4.5 preoperatively and 1.3 postoperatively. S4 sensory recovery was achieved in 58% of patients, S3+ in 33%, S3 in 7%, S0 in 2%, and improvement from baseline in 87%. Strength improved in 92%. Mean total active motion was 94.8%. Mean QuickDASH score was 36.1, and 96% reported improved or resolved symptoms. Preoperative pain was not significantly different between Avive cohort and controls (P = 0.618). Postoperative pain was significantly lower in cohort patients (1.3 ± 2.2 versus 2.7 ± 3.0, P = 0.001). In the Avive cohort, more had improved or resolved symptoms (P < 0.0001). Clinically important improvement in pain was reported in 64.9% of Avive group patients versus 40.8% of controls (P = 0.002). Conclusion:Avive contributes to improved outcomes in revision nerve decompression.

show abstract

“…• Vascular %NR Repair/hemostasis Ulnar nerve instability 7% 18 (2%-44%) 8,49 Inaccurate Diagnosis Failure of cubital tunnel surgery may be attributed to an inaccurate or incomplete initial diagnosis, and other pathologic conditions may confound the diagnosis. Cervical radiculopathy involving the C7-T1 or thoracic outlet syndrome (TOS) may cause dysesthesias or progressive motor deficit in the UN distribution and may exist in insolation or in conjunction with CuTS.…”

Section: Incomplete Decompressionmentioning

confidence: 99%

Management of Recalcitrant Cubital Tunnel Syndrome

Lauder

Chen

Bolson

et al. 2021

J Am Acad Orthop Surg

View full text Add to dashboard Cite

Cubital tunnel syndrome is a common upper extremity compressive neuropathy. Recalcitrant cubital tunnel syndrome poses diagnostic and treatment challenges. Potential etiologies of persistent or recurrent symptoms after surgical treatment include an inaccurate preoperative diagnosis, incomplete nerve decompression, iatrogenic injury, postsurgical perineural adhesions, irreversible nerve pathology, or conditions associated with secondary nerve compression. Confirmation of recalcitrant ulnar nerve pathology relies on a thorough history to consider symptoms and chronology, careful examination to quantify nerve function and to assess for focal nerve provocation, and objective testing to highlight a possible nerve lesion such as ultrasonography and electrodiagnostic testing. Conservative treatment may provide symptomatic relief; however, surgical management such as revision neuroplasty, neurolysis, nerve reconstruction, and/or anterior transposition may be indicated. Optimizing the biology of the local nerve environment is critical. No surgical treatment procedure has shown superiority over another; however, individualized treatment is emphasized to improve symptoms and maximize nerve recovery potential.

show abstract

Anterior submuscular transposition of the ulnar nerve

Cited by 29 publications

References 20 publications

Subcutaneous vs Submuscular Ulnar Nerve Transposition in Moderate Cubital Tunnel Syndrome

Subcutaneous vs Submuscular Ulnar Nerve Transposition in Moderate Cubital Tunnel Syndrome

Avive Soft Tissue Membrane Improves Outcomes of Revision Upper-extremity Nerve Decompression Surgery

Management of Recalcitrant Cubital Tunnel Syndrome

Contact Info

Product

Resources

About