Recovery of Ulnar Innervated Intrinsic Muscles following Anterior Transposition of the Ulnar Nerve

Abstract

A chart review of 26 patients who underwent anterior transmuscular transposition of the ulnar nerve and had a preoperative nerve conduction velocity less than 40 m/s across the elbow was completed. Patients with intrinsic muscle wasting before surgery were contacted for follow-up. One patient returned for follow-up evaluation. Preoperatively, this patient had complete numbness in the small and ring fingers, and severe intrinsic muscle wasting; left hand pinch and grip strengths were 4.5 kg and 34 kg, respectively. At the final evaluation, 67 months following surgery, left hand pinch and grip strengths were 10.9 kg and 54.5 kg, respectively. The patient had good intrinsic muscle reinnervation; his intrinsic hand muscle mass appeared to be equal to the uninvolved hand and there was no evidence of a Wartenberg's sign. This long term patient follow-up suggests that ulnar nerve transposition can facilitate the return of intrinsic muscle mass and function among patients with cubital tunnel syndrome.