Simple neurolysis for failed anterior submuscular transposition of the ulnar nerve at the elbow.

From 1996 to 2000, we reoperated nine patients totally dissatisfied after previous surgery for cubital tunnel syndrome. All patients had simple external neurolysis in situ of the transposed ulnar nerve. Only the anterior aspect of the ulnar nerve was dissected and released. Dense scarring around the ulnar nerve was found to be the main cause of recurrence but could not explain the three initial cases of persistent symptoms. All patients were reviewed 2 years after the secondary neurolysis. The patients were asked to describe their remaining symptoms and examination included palpation of the ulnar nerve at the elbow, Tinel's sign, two-point discrimination, and palpation of the scar. Pinch and grip strength were measured. According to the Wilson and Krout classification, there were four good results with complete alleviation of symptoms, four fair results, and one poor result. Simple neurolysis proved to be effective after failed anterior submuscular transposition of the ulnar nerve at the elbow.