Anterior intramuscular transposition of the ulnar nerve

Anterior intramuscular transposition is a seldom considered alternative to other surgical methods in management of cubital tunnel syndrome. Placement of the ulnar nerve anteriorly within the flexor-pronator mass removes it from a vulnerable subcutaneous position without extensive dissection. Of 52 sequential procedures, 45 extremities in 40 persons were available for follow-up (mean, 28 months after operation). By use of a 12-point scale of objective and subjective parameters, there were 87% good or excellent results; 4% were graded fair, and 9% were graded poor. Age, duration of symptoms, and conduction velocity were not of prognostic value. Although 69% of patients had other compressive neuropathy or tendinitis, this did not adversely affect results. Those with changes seen by electromyogram or work-related compensable injury had a poorer prognosis.