ELBOW ULNAR NEUROPATHY: TREATMENT BY ANTERIOR TRANSPOSITION OF THE ULNAR NERVE

ABSTRACT Objectives: Retrospective clinical evaluation of 31 patients who underwent ulnar nerve decompression at the elbow and subcutaneous anterior transposition. Methods: From January 2000 to December 2013, 71 patients underwent subcutaneous anterior transposition of the ulnar nerve. Thirty-one patients returned for evaluation. The mean follow-up period was 60 months. Patients were evaluated for the degree of satisfaction after surgery, paresthesia, pain, Tinel sign, Froment test and sensitivity test by esthesiometer, muscle strength of the intrinsic muscles and deep flexor of the fifth digit, visual analogic pain scale (VAS) and were subjected to the QuickDash questionnaire. Results: Thirty-nine per cent of patients had compression on the right side and 61% on the left side. Sixty-one percent were idiopathic, 35% post traumatic and 3% had Poems syndrome. Forty-eight per cent of patients were very much satisfied after surgery and 52% were satisfied. Forty-eight per cent had paresthesia after surgery and 52% did not. Conclusion: The ulnar neurolysis of the cubital tunnel with anterior subcutaneous transposition is a safe and effective technique for treating idiopathic or post-traumatic compressive neuropathy, with high success rate and excellent function for activities of daily living. Level of Evidence IV, Case Series.

Treatment of scaphoid nonunion with olecranon bone graft and compression screw

OBJECTIVE: To evaluate the outcome of olecranon bone graft and compression screw for the treatment of nonunion of the Lichtman type I scaphoid. METHOD: We evaluated 15 patients of 32 who underwent surgical treatment for nonunion of the Lichtman type I scaphoid with olecranon bone graft and screw compression. RESULTS: We obtained 100% consolidation in our sample. The mean flexion of the wrist on the affected side was 68° and 75° on the non-affected side. The average extension was 63° and 72°, respectively. The average grip strength was 35 kgf. This corresponds to 98% of the handgrip strength of the non-affected side, which was 37 kgf. The DASH score averaged 5 points. CONCLUSION: We believe that the use of bone graft obtained from the olecranon and secured with cannulated screw is a resolute technique for cases of linear nonunion of the Lichtmann type I scaphoid. It has the advantages of a new anesthesia for removal of the graft and the access is easy, providing a good exposure for removal and good aesthetic results. Level of evidence IV. Case series