Purpose
To evaluate the efficacy of a technique to preserve the extrinsic vascular supply
to the ulnar nerve after transposition and its effect on blood flow and clinical outcome.
Methods
We included 36 patients with cubital tunnel syndrome. The patients were randomly selected
to undergo vascular pedicles–sparing surgery for anterior ulnar nerve transposition
(VP group) or nerve transposition and artery ligation (non-VP group). Blood flow to
the ulnar nerve was estimated intraoperatively at 3 locations in the cubital tunnel
before and after transposition using a laser Doppler flowmeter. Clinical results at
3, 6, and 12 months after surgery were also compared between the 2 groups.
Results
The blood flow before ulnar nerve transposition was not significantly different between
the groups. Blood flow at all 3 locations after the ulnar nerve transposition was
significantly higher in the VP group than in the non-VP group. Blood flow in the non-VP
group reduced to values between 28% and 52% from the pre-transposition baseline values.
After surgery, no significant differences were observed in the clinical results between
the groups, except for the Disabilities of the Arm, Shoulder and Hand scores at 12
months after surgery, which was greater in the non-VP group.
Conclusions
The procedure of preserving the extrinsic vascular pedicles can prevent compromise
of blood flow to the ulnar nerve immediately after nerve transposition. However, this
procedure had no correlation to improved recovery of ulnar nerve function after surgery.
Type of study/level of evidence
Therapeutic II.
Key words
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Article info
Publication history
Published online: December 16, 2013
Accepted:
October 30,
2013
Received:
March 16,
2013
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
