title: The effect of vascular pedicle preservation on blood flow and clinical outcome following ulnar nerve transposition.
abstract: OBJECTIVE
  To evaluate the efficacy of a technique to preserve the extrinsic vascular supply to the ulnar nerve after transposition and its effect on blood flow and clinical outcome.
  
  
  METHODS
  We included 36 patients with cubital tunnel syndrome. The patients were randomly selected to undergo vascular pedicles-sparing surgery for anterior ulnar nerve transposition (VP group) or nerve transposition and artery ligation (non-VP group). Blood flow to the ulnar nerve was estimated intraoperatively at 3 locations in the cubital tunnel before and after transposition using a laser Doppler flowmeter. Clinical results at 3, 6, and 12 months after surgery were also compared between the 2 groups.
  
  
  RESULTS
  The blood flow before ulnar nerve transposition was not significantly different between the groups. Blood flow at all 3 locations after the ulnar nerve transposition was significantly higher in the VP group than in the non-VP group. Blood flow in the non-VP group reduced to values between 28% and 52% from the pre-transposition baseline values. After surgery, no significant differences were observed in the clinical results between the groups, except for the Disabilities of the Arm, Shoulder and Hand scores at 12 months after surgery, which was greater in the non-VP group.
  
  
  CONCLUSIONS
  The procedure of preserving the extrinsic vascular pedicles can prevent compromise of blood flow to the ulnar nerve immediately after nerve transposition. However, this procedure had no correlation to improved recovery of ulnar nerve function after surgery.
  
  
  METHODS
  Therapeutic II.
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan; Division of Rehabilitation, Shinshu University School of Medicine, Matsumoto, Japan; Department of Food and Nutritional Environment, College of Human Life and Environment, Kinjo Gakuin University, Nagoya, Japan; Department of Orthopaedic Surgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuou-city, Japan. Electronic address: k_nakarc5@yahoo.co.jp.
authors.forename: Koichi
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan; Division of Rehabilitation, Shinshu University School of Medicine, Matsumoto, Japan; Department of Food and Nutritional Environment, College of Human Life and Environment, Kinjo Gakuin University, Nagoya, Japan; Department of Orthopaedic Surgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuou-city, Japan.
authors.forename: Shigeharu
authors.initials: S
authors.lastname: Uchiyama
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan; Division of Rehabilitation, Shinshu University School of Medicine, Matsumoto, Japan; Department of Food and Nutritional Environment, College of Human Life and Environment, Kinjo Gakuin University, Nagoya, Japan; Department of Orthopaedic Surgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuou-city, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Ido
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan; Division of Rehabilitation, Shinshu University School of Medicine, Matsumoto, Japan; Department of Food and Nutritional Environment, College of Human Life and Environment, Kinjo Gakuin University, Nagoya, Japan; Department of Orthopaedic Surgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuou-city, Japan.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Itsubo
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan; Division of Rehabilitation, Shinshu University School of Medicine, Matsumoto, Japan; Department of Food and Nutritional Environment, College of Human Life and Environment, Kinjo Gakuin University, Nagoya, Japan; Department of Orthopaedic Surgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuou-city, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Hayashi
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan; Division of Rehabilitation, Shinshu University School of Medicine, Matsumoto, Japan; Department of Food and Nutritional Environment, College of Human Life and Environment, Kinjo Gakuin University, Nagoya, Japan; Department of Orthopaedic Surgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuou-city, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Murakami
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan; Division of Rehabilitation, Shinshu University School of Medicine, Matsumoto, Japan; Department of Food and Nutritional Environment, College of Human Life and Environment, Kinjo Gakuin University, Nagoya, Japan; Department of Orthopaedic Surgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuou-city, Japan.
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Sato
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan; Division of Rehabilitation, Shinshu University School of Medicine, Matsumoto, Japan; Department of Food and Nutritional Environment, College of Human Life and Environment, Kinjo Gakuin University, Nagoya, Japan; Department of Orthopaedic Surgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuou-city, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Imaeda
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan; Division of Rehabilitation, Shinshu University School of Medicine, Matsumoto, Japan; Department of Food and Nutritional Environment, College of Human Life and Environment, Kinjo Gakuin University, Nagoya, Japan; Department of Orthopaedic Surgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuou-city, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kato
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003097:Collateral Circulation / Q000502:physiology; D020430:Cubital Tunnel Syndrome / Q000503:physiopathology / Q000601:surgery*; D004551:Elbow Joint / Q000098:blood supply; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D017078:Laser-Doppler Flowmetry / Q000295:instrumentation; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D016067:Nerve Transfer / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology; D012039:Regional Blood Flow / Q000502:physiology; D013524:Surgical Flaps / Q000098:blood supply* / Q000294:innervation*; D014459:Ulnar Nerve / Q000098:blood supply* / Q000601:surgery
keywords: Ulnar nerve; blood flow; cubital tunnel syndrome; laser Doppler flowmeter; nerve transposition