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[Anatomical changes and dynamic analysis after anterior submuscular transposition in treating cubital tunnel
Zhigang Dai1, Ya Liu, Rusen Liu
1Department of Orthopaedics, the Affiliated Hospital of Weifang Medical College, Weifang Shadong, PR China.
Objective:
To produce anatomical theory evidence for treatment of cubital tunnel syndrome with anterior submuscular transposition.
Methods:
Of 32 patients with cubital tunnel syndrome, there were 22 males and 10 females, aged 17-73 years. The distribution of the branches of superior ulnar collateral artery and the relationship between superior ulnar collateral artery and ulnar nerve were observed; the position, scope and diameter of ulnar nerve lesion were also observed; the volume of new cubit tunnel was measured with dilator. Twenty cubituses of adult cadavers were made the models of anterior subcutaneous transposition and anterior submuscular transposition of ulnar nerve. Length changes of ulnar nerve in different situations were observed.
Results:
Superior ulnar collateral artery could be transposed with ulnar nerve, and new cubit tunnel was wide enough to contain ulnar nerve. In the context of anterior subcutaneous transposition, the ulnar nerve was lengthened by 7.55%+/-0.52% when compared with that of preoperation in the case of elbow extension, there was significant difference (P<0.05). In the context of anterior submuscular transposition, there was no significant difference in length of the ulnar nerves between preoperation and postoperation (P>0.05).
Conclusion:
Anterior submuscular transposition can overcome compression and pull of elbow on the ulnar nerve and has sufficient blood supply. New cubital tunnel is wide enough to contain ulnar nerve. Ulnar nerve anterior submuscular transposition is a useful method in treating cubital tunnel syndrome.
