Excursion of the ulnar nerve at the elbow following epicondylectomy or transposition

We studied the excursion of the ulnar nerve at the elbow following various surgical treatments for ulnar nerve compression in a cadaver model. The ulnar nerve length was measured in various positions of flexion in four situations: the normal anatomical position, following epicondylectomy and following submuscular and subcutaneous transposition. The changes in ulnar nerve length from 0 degrees to 120 degrees of flexion in the anatomical position and after epicondylectomy were significantly less than in the other situations. There was no significant difference in length between the normal anatomical situation and after epicondylectomy. On the theory that the least nerve excursion is better in the treatment of a nerve palsy, we recommend simple decompression or medial epicondylectomy for the treatment of tardy ulnar nerve palsy at the elbow.