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

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 was sutured in place beneath the reexposed nerve and covered by a strip of identical dimensions, which was also fixed to the soft tissues. The elbow joint was maintained in moderate flexion for 3 wk by a posterior plaster splint. It is believed that this sheathing, while permitting movement of the nerve with flexion and extension, prevents reencumbrance 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.