ULNAR NERVE COMPRESSION AT THE ELBOW - TH E RESULTS OF 51 MEDIAL CONDYLE OSTEOTOMIES ASSOCIATED WITH DECOMPRESSION

Purpose of the study Despite many publications concerning the physiopa thology and the treatment of Ulnar tunnel syndrome treatment remains c ontroversial. Material and methods The authors reviewed 51 patients op erated on for ulnar nerve entrapment at the elbow by neurolysis combin ed with medial epicondylectomy in case of luxation or subluxation of t he nerve. Average was 39 years, 74 per cent being males, 53 per cent m anual workers. According to Me Gowan's classification, 39 per cent wer e grade I, 12 per cent grade IIA, 20 per cent grade IIB and 29 per cen t grade III. Results Few postoperative complications occurred: one pos toperative hematoma, 4 painful scars without neurinoma, and one case o f an elbow extension lag of 15 degrees. With an average follow-up of 4 ,6 years, 39 per cent of the patients were cured, 27 per cent improved , 31 per cent unchanged and none worsened. As in all others techniques , excellent results only occurred in grade I and IIA. Discussion Anato mical and physiopathological studies show that compression, friction a nd elongation are the 3 components of the ulnar tunnel syndrome. The d ifferent conservative and surgical treatments are analyzed, taking int o account both advantages and drawbacks. The medial epicondylectomy wi th decompression allows a <<mini transposition>> of the nerve but keep s the vascularization and the nerve intact. Its simplicity and our res ults are confirmed by all other series analyzed in the literature.