[Compression of the ulnar nerve at the elbow. Results of a series of 51 medial epicondyle osteotomies associated with decompression].

PURPOSE OF THE STUDY: Despite many publications concerning the physiopathology and the treatment of Ulnar tunnel syndrome treatment remains controversial.

MATERIAL AND

METHODS

The authors reviewed 51 patients operated on for ulnar nerve entrapment at the elbow by neurolysis combined with medial epicondylectomy in case of luxation or subluxation of the nerve. Average was 39 years, 74 per cent being males, 53 per cent manual workers. According to Mc Gowan's classification, 39 per cent were grade I, 12 per cent grade IIA, 20 per cent grade IIB and 29 per cent grade III.

RESULTS

Few postoperative complications occurred: one postoperative hematoma, 4 painful scars without neurinoma, and one case of an elbow extension lag of 15 degrees. With an average follow-up of 4.6 years, 39 per cent of the patients were cured, 27 per cent improved, 31 per cent unchanged and none worsened. As in all others techniques, excellent results only occurred in grade I and IIA.

DISCUSSION: Anatomical and physiopathological studies show that compression, friction and elongation are the 3 components of the ulnar tunnel syndrome. The different conservative and surgical treatments are analyzed, taking into account both advantages and drawbacks. The medial epicondylectomy with decompression allows a "mini transposition" of the nerve but keeps the vascularization and the nerve intact. Its simplicity and our results are confirmed by all other series analyzed in the literature.