Among the entrapment neuropathies, ulnar neuropathy at the elbow is second
only to carpal tunnel syndrome in frequency; however, diagnosis and managem
ent are considerably more difficult in ulnar lesions than in carpal tunnel
syndrome. Electrodiagnosis is the most important means of identifying and l
ocalizing ulnar neuropathies at the elbow, but even sophisticated technique
s may sometimes fail to confirm diagnosis and localization preoperatively.
Mild lesions are best managed conservatively. More severe lesions require s
urgical intervention. Simple decompression is now preferred over transposit
ion in the majority of cases, but careful correlation of electrodiagnostic
abnormalities and findings at surgery are necessary to ensure optimal outco
me.