What are the advantages and disadvantages of a submuscular transposition for ulnar neuropathy?

Updated: Jun 08, 2018
  • Author: Charles F Guardia, III, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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A submuscular transposition offers the best results with the fewest recurrences with severe ulnar nerve compression. [176] It is the best salvage procedure when previous surgery has failed because it places the nerve in an unscarred bed. It also works well for patients who are very thin, in whom a subcutaneous transposition may result in an area of hypersensitivity over the transposed nerve. Many consider an anterior submuscular transposition the procedure of choice for symptomatic athletes who throw.

The disadvantage of a submuscular transposition is that it is a technically demanding procedure. Because of the extensive dissection involved, postoperative recovery is more difficult, and there is a 5-10% risk of elbow flexion contracture. Patients may also develop extensive scar formation from the procedure, and revision is difficult if the patient has a recurrence.

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