Validity of nerve conduction velocity studies after anterior transposition of the ulnar nerve

Anterior submuscular transposition

The article begins with the history of the development of anterior submuscular transposition. The technique for musculofascial lengthening and correction of the pathophysiology of ulnar nerve compression are described along with results and complications. Also described is an approach to the patient for whom ulnar nerve surgery has failed.

Short segment stimulation of the anterior transposed ulnar nerve at the elbow

OBJECTIVE

To determine whether short segment stimulation after anterior subcutaneous transposition of the ulnar nerve reaches normal values and correlates with postoperative clinical findings.

DESIGN

Comparative cross-sectional study.

SETTING

Outpatient clinic of a university department of physical medicine and rehabilitation.

PATIENTS

Nineteen patients (15 men, 4 women) with 21 surgically treated ulnar neuropathies at the elbow; and 19 healthy controls (11 men, 8 women) with 24 measured nerves.

INTERVENTIONS

Assessed motor function of ulnar innervated muscles and staged into 4 categories; used questionnaire to assess clinical course of the nerve lesion and graded into 5 categories; took electrophysiologic recordings to measure motor conduction velocity and compound muscle action potentials; and studied short segment stimulation across elbow and lower arm.

MAIN OUTCOME MEASURES

Mean +/- standard deviation of ulnar short segment conduction time across the elbow, amplitude and motor conduction velocity; grading of ulnar nerve lesions; grading of the course of disease after surgery; and logistic regression and correlation (Spearman's correlation coefficient) for electrophysiologic and clinical parameters.

RESULTS

Sixteen nerves showed focal conduction slowing in patients. No significant correlation between the course of disease and electrophysiologic parameters was seen. For stepwise logistic regression, there was a significant effect between grade of nerve lesion and amplitude, but no significant effect between the course of disease and electrophysiologic parameters.

CONCLUSION

A focal conduction slowing across the elbow after anterior subcutaneous transposition does not correlate with postoperative clinical findings.