Medial Epicondylectomy for Tardy Ulnar Palsy

ABSTRACT

We have reported our experience with 5 cases, each of whom had tardy ulnar palsy, which was treated by medial epicondylectomy without anterior transplantation of ulnar nerve, and each of whom had good result in 2 years follow-up study. All patients had cubitus valgus deformity which was followed to the fracture-dislocation of the elbow region. The operative procedure employed in this series is carried out with the patient spine, the humerus abducted and externally rotated, and the elbow flexed so that the extensor surface of the forearm may rest comfortably on a padded arm board. A skin incision 5 to 6 cm long made parallel to the ulnar nerve but a centimeter or more in front of it. Centered on the prominence of the condyle. After fully exposing the medial epicondyle and the supracondylar ridge subperiosteally, they are removed with rongeurs. No sharp edge should be left and the bone should be removed sufficiently checking X-ray during the operation for the evaluation of bone shape hidden in the soft tissues. Following epicondylectomy, all patients gained relief from pain and had gradual return of motor function. Because of less risk to traumatize to nerve branches, to interfere with blood supply, and to adhere the neighboring tissues, and of ability to move the elbow through a full range immediately, we believe this method gives results superior to anterior transplantation operation.