title: Anterior subcutaneous transposition of the ulnar nerve improves neurological function in patients with cubital tunnel syndrome.
abstract: Although several surgical procedures exist for treating cubital tunnel syndrome, the best surgical option remains controversial. To evaluate the efficacy of anterior subcutaneous transposition of the ulnar nerve in patients with moderate to severe cubital tunnel syndrome and to analyze prognostic factors, we retrospectively reviewed 62 patients (65 elbows) diagnosed with cubital tunnel syndrome who underwent anterior subcutaneous transposition. Preoperatively, the initial severity of the disease was evaluated using the McGowan scale as modified by Goldberg: 18 patients (28%) had grade IIA neuropathy, 20 (31%) had grade IIB, and 27 (42%) had grade III. Postoperatively, according to the Wilson & Krout criteria, treatment outcomes were excellent in 38 patients (58%), good in 16 (25%), fair in 7 (11%), and poor in 4 (6%), with an excellent and good rate of 83%. A negative correlation was found between the preoperative McGowan grade and the postoperative Wilson & Krout score. The patients having fair and poor treatment outcomes had more advanced age, lower nerve conduction velocity, and lower action potential amplitude compared with those having excellent and good treatment outcomes. These results suggest that anterior subcutaneous transposition of the ulnar nerve is effective and safe for the treatment of moderate to severe cubital tunnel syndrome, and initial severity, advancing age, and electrophysiological parameters can affect treatment outcome.
authors.affiliation: Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.affiliation: Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China.
authors.forename: Pei-Xun
authors.initials: PX
authors.lastname: Zhang
authors.affiliation: Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China.
authors.forename: Zhang
authors.initials: Z
authors.lastname: Peng
authors.affiliation: Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Xue
authors.affiliation: Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China.
authors.forename: Tian-Bing
authors.identifier: 0000-0002-9883-6812
authors.initials: TB
authors.lastname: Wang
authors.affiliation: Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China.
authors.forename: Bao-Guo
authors.identifier: 0000-0001-8436-5266
authors.initials: BG
authors.lastname: Jiang
keywords: NSFC grant; Wilson & Krout criteria; age; anterior transposition; electrophysiology; modified McGowan scale; motor nerve conduction velocity; nerve regeneration; neural regeneration; peripheral nerve injury; sensory nerve conduction velocity; ulnar nerve; ulnar nerve compression syndrome