Ulnar Nerve Decompression With Subcutaneous Transposition

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Neurology

Background:

• Medial-sided elbow injuries are prevalent in throwing athletes due to overuse and early specialization.
• Repetitive valgus stress and elbow flexion/extension impact elbow ligaments, dynamic support, and the ulnar nerve.

Purpose of the Study:

• To evaluate the efficacy of ulnar nerve decompression with subcutaneous transposition for cubital tunnel syndrome in athletes.
• To assess symptom improvement and return-to-sport outcomes following surgical intervention.

Main Methods:

• Surgical technique involves decompression of the ulnar nerve proximal and distal to the medial epicondyle.
• Subcutaneous transposition of the ulnar nerve is performed, secured with a sling from the medial intermuscular septum.
• Careful identification and protection of the medial antebrachial cutaneous nerve are maintained throughout the procedure.

Main Results:

• Symptom improvement in patients undergoing decompression and transposition exceeds 90%.
• Return to previous or higher levels of athletic performance ranges from 60% to 90% in overhead and throwing athletes.

Conclusions:

• Ulnar nerve decompression and transposition is a reliable surgical option for managing cubital tunnel syndrome, leading to significant symptom relief.
• While effective for symptom resolution, the impact on return-to-sport outcomes for overhead and throwing athletes is variable.