A technique for relief of motor and sensory deficits occurring after anterior ulnar transposition

Abstract

✓ A method is described for relief of dysesthetic pain or progression of the motor and sensory deficits in previously transposed ulnar nerves that have become entrapped in the operative scar. After an external neurolysis to prevent a recurrence, a Silastic strip 15 cm long and 3 cm wide is sutured in place beneath the re-exposed nerve and covered by a strip of identical dimensions, which is also fixed to the soft tissues. The elbow joint is maintained in moderate flexion for 3 weeks by a posterior plaster splint. It is believed that this sheathing, while permitting movement of the nerve with flexion and extension, prevents re-encumbrance with adhesions. In nine cases so treated, compressive adhesions were encountered along the course of the transposed nerve rather than entrapment at the point where it has previously been brought out through the fascia. After operation, five out of nine patients maintained significant lasting motor and sensory improvement, verified bioelectrically. Minor sensory improvement was experienced by two others, and two remained unchanged.