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Anatomical basis for a technique of ulnar nerve transposition

Bases anatomiques d'une technique de transposition du nerf cubital

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Summary

There are five major anatomical locations where the ulnar nerve may be compressed near the elbow. Multiple sites of compression are often noted clinically; in other cases, the site of compression is difficult to identify. Clinical experience and results of a series of 20 anatomical dissections suggest that local decompression or subcutaneous transfer may be performed without necessarily exposing all five locations, posing a risk of incomplete decompression. Submuscular transfer of the ulnar nerve decompresses all five locations simultaneously and thus theoretically may be more reliable. The potentially superior results predicted by this anatomical investigation have been confirmed in a clinical case review. Submuscular transposition of the ulnar nerve is reliable and safe, not only in the primary treatment of ulnar neuropathy at the elbow but also in revision of previous operations.

Résumé

Il existe cinq points près du coude où le nerf cubital peut être comprimé. Plusieurs de ces points peuvent être trouvés cliniquement mais dans d'autres cas le point de compression est difficile à identifier. A partir de plusieurs expériences cliniques et du résultat d'une série de vingt dissections anatomiques, l'auteur suggère que la décompression et le transfert sous-cutané du nerf peuvent être réalisés sans que soient exposées les cinq localisations préférentielles de compression. Le transfert sous-musculaire du nerf cubital décomprime les cinq localisations simultanément et devient théoriquement plus fiable. L'amélioration des résultats prévus par ce travail anatomique a été confirée dans un cas clinique spécifique. La transposition sous-musculaire du nerf cubital est simple, fiable, non seulment comme traitement initial des neuropathies cubitales au niveau du coude mais aussi dans les reprises chirurgicales.

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Amadio, P.C. Anatomical basis for a technique of ulnar nerve transposition. Surg Radiol Anat 8, 155–161 (1986). https://doi.org/10.1007/BF02427843

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