Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: General Orthopaedics
Abstract number: 25829
SUBMUSCULAR VERSUS SUBCUTANEUS ANTERIOR TRANSPOSITION OF
THE ULNAR NERVE - 15 YEARS OF EXPERIENCE
Sofia FERNANDES, Rui CERQUEIRA, José FRAGA, Tiago BARBOSA, Joăo
OLIVEIRA, Vitor CAETANO
Centro Hospitalar do Alto Ave - Guimarăes, Guimarâes (PORTUGAL)
Introdution: The ulnar nerve entrapment at the elbow is common in clinical practise.
The surgical techniques to treat this disease include simple decompression,
decompression with medial epicondylectomy; anterior subcutaneous, intramuscular
or submuscular transposition. The aim of this study is to compare the results of
subcutaneous anterior transposition with submuscular and evaluate the efficacy of
these techniques. Material and Methods: 70 patients submitted to subcutaneous or
submuscular transposition from 1993 to 2008 were evaluated. The disease was
diagnosticated with clinical history, physical examination and/or complementary
exams. Previously to surgery they underwent at least 6 months of conservative
treatment without benefits. The patients were evaluated according to the McGowan
classification and Modified Bishop Scoring System. Morbidity, complications and
recurrence were registered. Results: 45 patients were female e 25 male; there were
bilateralism in 7 and 2 with recurrence of the disease; 50 (71%) underwent
subcutaneous transposition and 20 (29%) submuscular; 42 (60%) had the disease in
the dominant side. Regardless of what type of surgery was done, 63 (90%) consider
to have improve their condition; 49 (69%) had complete resolution of the
paresthesias and 40 (57%) had complete pain resolution. The medium time of
symptoms resolution was lesser in the submuscular transposition group. Discussion:
The subcutaneous transposition is a simple surgical technique which permits
immediate mobilization after surgery, but with more nerve exposition to trauma. The
subcutaneous technique has better results in recurrences, lesser nerve exposition to
trauma; but is technically more complex and needs more time to recover after
surgery.
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