[How to avoid operative injury to Martin-Grüber communicating branch in the transmuscular medial approach of the elbow?].

The incidence of Martin-Grüber medio-ulnar communicating branch (MUCB), from median nerve to ulnar nerve, is about 20%. To avoid operative injury to MUCB, the authors suggest some modifications to the medial approach of the elbow. They suggest medial aponeurotomy of the anterior compartment of the forearm, disinsertion of the medial epicondylar muscles with dissection between the flexor carpi ulnaris (FCU) and the other medial epicondylar muscles, not exceeding 3 cm distally. This allows a valuable exposure of the elbow joint through a medial approach, with FCU disinsertion and ulnar nerve transposition preserving the ulnar nerve vascularization, without injury to the MUCB.