Turkish Neurosurgery
Analysis of subcutaneous anterior transposition versus in-situ decompression of ulnar nerve with force transducer in cadaver specimen
BEKIR ERAY KILINC1, HALUK CELIK2, YUNUS OC3, ELIF NEDRET KESKINOZ4, RUHAT UNLU1, BARIS YILMAZ1
1Health Science University, Fatih Sultan Mehmet Training and Reseach Hospital, Istanbul, Orthopedics, Istanbul,
2Health Science University, Umraniye Training and Reseach Hospital, Istanbul, Orthopedics, Istanbul,
3Medilife Hospital, Orthopedics, Istanbul,
4Acibadem University, Anatomy, Istanbul,
DOI: 10.5137/1019-5149.JTN.27190-19.2
Aim:To evaluate the changes in the pressure values of the ulnar nerve after in situ decompression and anterior subcutaneous transposition of the ulnar nerve.Material and Methods:This experimental study was conducted at Acibadem University in April 2019. The ulnar nerve was released in the postcondylar groove. An ultrathin (100 lm) force transducer was embedded between the posterior of the ulnar nerve and the anterior of the medial epicondyle. The elbow joint was flexed from full extension position to maximum flexion and was measured to obtain the maximum stress at 0°, 45°, 90°, and 135° of flexion. Then, the ulnar nerve was transposed anterior subcutaneously. The same measurement was applied to the two procedures. Data were compared between the two surgical techniquesResults:Our study was performed on eight fresh frozen cadavers. The mean age was 67.25 ± 12.2 years. Mean values of 0°, 45°, 90°, and 135° of flexion after the ulnar nerve in situ decompression were 0.41, 0.9, 1.7, and 4.3 N, respectively. Mean values of 0°, 45°, 90°, and 135° of flexion after anterior transposition of the ulnar nerve were 0.3, 0.73, 1.63, and 2.15 N, respectively. No significant difference was noted between the two groups in terms of 0°, 45°, and 90° of flexion values. There was a significant difference between the two groups in the 135° of flexion measurement values.Conclusion:Anterior transposition is a more appropriate technique than in situ decompression in the treatment of cubital tunnel syndrome that does not respond to conservative treatment regardless of the severity of the symptom.
Corresponding author : BEKIR ERAY KILINC