title: Outcome of neurolysis combined with anterior submuscular transfer of ulnar nerve in McGowan Grade II and III tardy ulnar nerve palsy.
abstract: OBJECTIVE
  To see the impact of combined neurolysis and submuscular transposition approach in patients with tardy ulnar nerve palsy of Mc Gowan grades II and III.
  
  
  METHODS
  The descriptive case series was conducted at King Edward Medical University, Mayo Hospital, Lahore, between January 2013 and January 2014, and comprised patients with positive nerve conduction study and electromyography, aged above 14 years with McGowan grades II and III tardy ulnar nerve palsy of any aetiology. They were treated by a single surgeon and his team. Anterior submuscular transposition with internal neurolysis under loupes was performed. Improvement in hand function was determined with Quick Disabilities of the Arm, Shoulder and Handscore 6 months postoperatively. Data was analysed using SPSS 16.
  
  
  RESULTS
  Of the 20 consecutive patients in the study, 14(70%) were males and 6(30%) were females with a standard deviation of 16.35(range: 14-60 years). Six-month postoperatively, Quick Disabilities of the Arm, Shoulder and Handscore had a mean improvement from 43 to 21 (standard deviation from 6.46 to 7.51) supporting the evidence that 18(90%) patients had significant improvement in hand function. There was 1(5%) excellent, 13(65%) good, 4(20%) fair and 2(10%) poor functional outcomes.
  
  
  CONCLUSIONS
  Patients with Mc Gowan grades II and III tardy ulnar nerve palsy showed good functional outcome when internal neurolysis was combined with submuscular transposition.
authors.affiliation: Mayo Hospital, Lahore.
authors.forename: Ayesha
authors.initials: A
authors.lastname: Saeed
authors.affiliation: Mayo Hospital, Lahore.
authors.forename: Usman
authors.initials: U
authors.lastname: Zafardar
authors.affiliation: Mayo Hospital, Lahore.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Awais
authors.affiliation: Mayo Hospital, Lahore.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Akram
keywords: Cubital tunnel syndrome, Quick DASHscore, Submuscular transposition neurolysis.