Submuscular Transposition of the Ulnar Nerve

Siegel, David B.

doi:10.1016/s0749-0712(21)00328-0

Cited by 31 publications

(3 citation statements)

References 5 publications

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“…The treatment of cubital tunnel syndrome is controversial (Dellon, 1989;Gellman and Campion, 1996;Jackson and Hotchkiss, 1996;Kuschner, 1996;Osterman and Davis, 1996;Plancher, 1996;Siegel, 1996). Some authors recommend in situ decompression (Gellman, 1996), while others recommend transposition -which can be submuscular, intramuscular, or subcutaneous (Kleinman and Bishop, 1989;Osterman and Davis, 1996;Plancher, 1996;Siegel, 1996). In a metanalysis of the available literature, Dellon (1989) concluded that submuscular transposition produced better results in severe cubital tunnel syndrome with marked sensory or motor changes.…”

Section: Discussionmentioning

confidence: 99%

The Ulnar Nerve at the Elbow and its Local Branching: An Anatomic Study

Gonzalez

Lotfi

Bendre

et al. 2001

Journal of Hand Surgery

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Thirty nine cadaver elbows were dissected and the branching of the ulnar nerve, as well as the cubital tunnel and adjacent potential sites of nerve compression were studied. An arcade of Struthers was present in 26 specimens and Osborne's ligament was present in all specimens. A discrete flexor pronator aponeurosis overlying the ulnar nerve was present in 17 specimens. An average of one (range, 0-3) capsular nerve branches were noted. These originated an average 7 mm proximal (range, 45 mm proximal to 24 mm distal) to the medial epicondyle. An average of three (range, 1-6) motor branches to the flexor carpi ulnaris muscle were noted, and one of these originated proximal to the medial epicondyle in two specimens. Significant variation was noted in the capsular and motor branching of the ulnar nerve. Care must be taken to identify the motor branches of the ulnar nerve when performing a transposition.

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Section: Discussionmentioning

confidence: 99%

The Ulnar Nerve at the Elbow and its Local Branching: An Anatomic Study

Gonzalez

Lotfi

Bendre

et al. 2001

Journal of Hand Surgery

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“…In this case the nerve was not covered with nerve wrapping. However, if substantial scarring is noted, we cover the nerve with vein graft wrapping as described by Sotereanos et al 14 since in our practice we do not have access to porcine small intestine submucosa (SIS, Axoguard Nerve Connector) nor cross-linked bovine collagen type I (CLC, Integra NeuraGen®). However, these biomaterials could be used for wrapping as well.…”

Section: Case Discussionmentioning

confidence: 99%

Total Elbow Arthroplasty and Antegrade Posterior Interosseous Flap for Infected Posttraumatic Arthritis with an Active Fistula. A Rationale for Comprehensive Treatment. Case Report

Farías-Cisneros

Martínez-Peniche

Olguín-Delgado

et al. 2022

Journal of Shoulder and Elbow Arthroplasty

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The indication for total elbow arthroplasty (TEA) for primary and posttraumatic elbow arthritis has increased, however, its indication after infection remains elusive. Wound closure about the elbow increases the challenge of treating a previously infected elbow, often necessitating soft tissue coverage with local or regional flaps. We present a 75-year-old male patient with an elbow infection following a failed complex intraarticular fracture open reduction and internal fixation of the distal humerus. Initially, he presented with severe functional impairment and pain, also with an active fistula with serous exudate, whose culture was positive for Cutinebacterium acnes. Septic hardware loosening, and septic nonunion with intraarticular involvement of the left elbow was diagnosed. The patient underwent hardware removal, fistulectomy, serial irrigation and debridement and a pedicled antegrade posterior interosseous artery (PIA) flap on staged surgical treatment. Finally, after ruling out infection persistence, a TEA was performed. We aim to report the outcome of a patient treated with a TEA in the context of a previously infected elbow with soft tissue coverage with an antegrade PIA flap. Comprehensive treatment must be done in an appropriate manner, to obtain an expedited and desirable outcome.

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“…We assumed that submuscular transposition of the ulnar nerve was the most definitive management for this condition and would be the surgical treatment of choice if simpler procedures failed (Dellon, 1989;Holmberg, 1991;Rogers et al, 1991;Osterman and Davis, 1996;Siegel, 1996). A failure of submuscular transposition itself, either as a primary treatment or as a salvage procedure, was considered an endpoint of the model.…”

Section: Article In Pressmentioning

confidence: 99%

The Surgical Treatment of Cubital Tunnel Syndrome: A Decision Analysis

Brauer

Graham

2007

J Hand Surg Eur Vol

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The objective of our study was to use decision analysis to compare four common surgical treatments for cubital tunnel syndrome: simple decompression of the cubital tunnel, medial epicondylectomy, anterior subcutaneous transposition and anterior submuscular transposition. The variables used for this decision analysis model were based on data from the literature. Extensive sensitivity analyses were carried out to test the impact of the values given to these variables on the outcome of the model. The highest expected utility, 0.973, was associated with simple decompression. The expected utility was 0.969 for subcutaneous transposition and 0.965 for submuscular transposition. Medial epicondylectomy had the lowest expected utility at 0.961. Simple decompression remained the preferred strategy in extensive one-way sensitivity analyses.

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Submuscular Transposition of the Ulnar Nerve

Cited by 31 publications

References 5 publications

The Ulnar Nerve at the Elbow and its Local Branching: An Anatomic Study

The Ulnar Nerve at the Elbow and its Local Branching: An Anatomic Study

Total Elbow Arthroplasty and Antegrade Posterior Interosseous Flap for Infected Posttraumatic Arthritis with an Active Fistula. A Rationale for Comprehensive Treatment. Case Report

The Surgical Treatment of Cubital Tunnel Syndrome: A Decision Analysis

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