Percutaneous Nucleotomy--General Orthopaedics: Miscellanea

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Submuscular Transposition of the Ulnar Nerve. Janes-Peter-C. Mann-Ronald-J. Farnworth-Todd-K. Clinical Orthopaedics and Related Research. 1989 Jan. 238. pp 225-232. A retrospective study of 26 submuscular ulnar nerve transpositions was performed with the specific use of grip and pinch analysis to evaluate this form of objective testing. Twenty-six patients were treated by submuscular transposition of the ulnar nerve between 1981 and 1985 and were followed an average of 21 months. Preoperative and postoperative analysis consisted of subjective questioning, clinical examination, quantitative two-point discrimination, quantitative pinch and grip analysis, and electromyographic (EMG) and nerve conduction velocity (NCV) evaluation. Many of the patients suffered from associated problems such as alcohol abuse, diabetes mellitus, and concurrent Guyon's canal compression, which adversely affected the outcome. Subjectively, 62 per cent were improved, 31 per cent were no better, and 7 per cent were worse. Clinical examination demonstrated 46 per cent improved, 35 per cent no better, and 19 per cent worse. Quantitative two-point discrimination was better in 59 per cent, unchanged in 26 per cent, and worse in 15 per cent. Quantitative pinch and grip analysis revealed 28 per cent improved, 56 per cent with little improvement, or the same, and 16 per cent worse, while EMG/NCV showed one-third of the patients in each category postoperatively. Quantitative pinch and grip analysis provided good preoperative and postoperative documentation, which is absent from previous studies in the literature concerning ulnar nerve transportation.