What are the advantages and disadvantages of a medial epicondylectomy 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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Answer

The main advantage of medial epicondylectomy is that it provides a more thorough decompression of the ulnar nerve than a simple release does. This results in a minitransposition of the ulnar nerve. Compared with decompression plus anterior transposition, medial epicondylectomy better preserves the blood supply to the nerve, causes less injury to the nerve, and preserves the small proximal nerve branches that might be sacrificed with an anterior transposition. [179]

The primary disadvantage is that it allows greater migration of the ulnar nerve with elbow flexion. There is a potential for elbow instability if the collateral ligaments are damaged. Bone pain and nerve vulnerability at the epicondylectomy site may occur. Compared with simple decompression, medial epicondylectomy is more likely to result in elbow stiffness or an elbow flexion contracture. In addition, it is often a poor choice for athletes who throw because of the significant stresses placed on the medial aspect of the elbow joint.


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