title: Randomized, prospective study comparing ulnar neurolysis in situ with submuscular transposition.
abstract: OBJECTIVE
  To help clarify the optimal surgical strategy for idiopathic, symptomatic ulnar nerve compression at the elbow in terms of overall outcome and morbidity by using objective criteria.
  
  
  METHODS
  Forty-four surgical candidates were recruited prospectively and were randomized into the neurolysis (n = 23) or transposition (n = 21) arm of the study. Preoperative and postoperative outcomes were assessed symptomatically and by performance on McGowen and Louisiana State University Medical Center grading systems at 1 month, 6 months, and 1 year.
  
  
  RESULTS
  Both procedures were equally effective in producing objective neurological improvement (61% in the neurolysis group, 67% in the transposition group). Wound complications, however, were more significant in the transposition group. Three of 21 in the transposition group compared with 0 of 23 in the neurolysis group experienced a deep wound infection.
  
  
  CONCLUSIONS
  Idiopathic symptomatic ulnar nerve compression at the elbow is adequately treated by both neurolysis in situ and submuscular transposition. Submuscular transposition was associated with a higher incidence of complications. The authors therefore suggest the simpler procedure of neurolysis in situ as the treatment of choice. Submuscular transposition remains appropriate in certain circumstances.
authors.affiliation: Department of Neurosurgery, Royal North Shore Hospital, North Shore Medical Centre, St. Leonards, Sydney, New South Wales, 2065, Australia. biggs@idx.com.au
authors.forename: Michael
authors.initials: M
authors.lastname: Biggs
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Curtis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D011446:Prospective Studies; D012189:Retrospective Studies; D017769:Ulnar Nerve Compression Syndromes / Q000145:classification / Q000473:pathology / Q000601:surgery*