Poster 331 Ultrasound to Diagnose Persistent Nerve Compression After Ulnar Nerve Transposition Surgery: A Case Report

Abstract OBJECTIVE: To describe a simple retractor integrated endoscopic technique for treating idiopathic solitary compression neuropathies with special attention to the anterior transposition of the ulnar nerve and tarsal tunnel release, and to present the clinical results. METHODS: Eleven patients with ulnar sulcus syndrome, eight with tarsal tunnel syndrome, and one with meralgia paraesthetica (seven females and 13 males; age range, 12–64 yr) were treated with endoscopic anterior ulnar nerve transposition and in situ decompression of the tibial (eight patients) and lateral femoral cutaneous nerves (one patient), respectively. The selection criteria were: classical nerve compression symptoms, failed conservative treatment, abnormal electrophysiology, and a nonviolated anatomic region. The degree of nerve compression (after Dellon) was rated as moderate in five out of 20 patients and as severe in 15 out of 20 patients. Electrophysiological studies were conducted independently by physicians specializing in these techniques. Postoperative recovery was evaluated according to the nine-point Bishop rating system. RESULTS: Of the 11 patients with anterior ulnar nerve transposition, seven scored excellent, three scored good, and one scored fair (mean follow-up, 15.5 mo; range, 6–27 mo). Five patients with tarsal tunnel release scored excellent and three scored good (mean follow-up, 10.1 mo; range, 3–24 mo). The patient with meralgia paraesthetica showed an excellent score at 28 months after surgery. There were no technical or postoperative complications. None of the operations had to be converted to open surgery. CONCLUSION: We describe a new endoscopic technique for transposing the ulnar nerve and decompressing the tibial nerve. This technique could be extrapolated to release other single nerve entrapments. The simplicity of the technique, and our preliminary clinical results, may encourage other groups to adapt this method.

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Intraoperative anterior shoulder dislocation during ulnar nerve transposition: a case report

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2020.04.012 ◽

2020 ◽

Vol 29 (8) ◽

pp. e317-e319

Author(s):

Lili E. Schindelar ◽

Pedro K. Beredjiklian

Keyword(s):

Case Report ◽

Ulnar Nerve ◽

Shoulder Dislocation ◽

Anterior Shoulder Dislocation ◽

Ulnar Nerve Transposition ◽

Nerve Transposition

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A CASE REPORT OF ACUTE CUBITAL TUNNEL SYNDROME CAUSED BY VENOUS THROMBOSIS

Hand Surgery ◽

10.1142/s0218810415720016 ◽

2015 ◽

Vol 20 (01) ◽

pp. 137-139 ◽

Cited By ~ 3

Author(s):

Yoshihiro Abe ◽

Masahiko Saito

Keyword(s):

Case Report ◽

Venous Thrombosis ◽

Ulnar Nerve ◽

Cubital Tunnel Syndrome ◽

Nerve Compression ◽

Ulnar Neuropathy ◽

Cubital Tunnel ◽

Ulnar Nerve Compression ◽

Compression Neuropathy ◽

Tunnel Syndrome

Compression neuropathy of the ulnar nerve at the elbow is well-recognised as cubital tunnel syndrome (CuTS). Many causes of ulnar neuropathy at the elbow have been identified. A previously unreported finding of ulnar nerve compression in the cubital tunnel caused by a thrombosed proximal ulnar recurrent artery vena comitans is described.

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Performance and Return to Sport Following Ulnar Nerve Transposition/Decompression in Professional Baseball Players

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118s00166 ◽

2018 ◽

Vol 6 (7_suppl4) ◽

pp. 2325967118S0016

Author(s):

Brandon J. Erickson ◽

Peter Nissen Chalmers ◽

John D’Angelo ◽

Kevin Ma ◽

Anthony A. Romeo

Keyword(s):

Ulnar Nerve ◽

Performance Metrics ◽

Return To Sport ◽

Professional Baseball ◽

Baseball Players ◽

Nerve Decompression ◽

Ulnar Nerve Transposition ◽

Significant Difference ◽

And Performance ◽

Nerve Transposition

Background: Isolated ulnar nerve decompression/transposition is an uncommon surgery amongst professional baseball players. Purpose: To determine the rate of return to sport (RTS) and performance upon RTS in professional baseball players following isolated ulnar nerve decompression/transposition, including those who required an ulnar nerve transposition/decompression following ulnar collateral ligament reconstruction (UCLR), and to determine if outcomes differ between players with isolated ulnar nerve decompression/transposition and matched controls. Hypothesis: There is a high rate of RTS in professional baseball players undergoing isolated ulnar nerve decompression/transposition with no significant difference in RTS rate or performance (specifically related to the primary outcome performance variables of earned run average (ERA), WHIP ((walks +hits)/innings pitched), wins above replacement (WAR), and on base + slugging percentage (OPS)) between cases and controls. Methods: All professional baseball players who underwent isolated ulnar nerve decompression/transposition between 2010-2016 were included. Demographic and performance data (pre and post surgery) for each player was recorded. Performance metrics were then compared between cases and a group of matched controls. Results: Overall 52 players, 83% pitchers (14 who underwent prior UCLR) were included. Most surgeries (92%) were anterior subcutaneous transpositions. Overall, 62% of players were able to successfully RTS and 56% returned to the same or a higher level. There was no significant difference between cases and controls in the majority of performance metrics pre-operative or post-operatively, specifically ERA, WHIP, WAR, and OPS. When players who had a UCLR prior to their ulnar nerve transposition/decompression were compared to controls with a history of a UCLR but who did not go on to have an ulnar nerve transposition/decompression, the only performance difference of all the recorded metrics was cases allowed more walks per 9 innings (4.4 vs. 2.8; p=0.011). Conclusion: Anterior subcutaneous transposition is the most common surgery in professional baseball players to address ulnar nerve compression. Players have a 62% rate of RTS. Upon RTS, players performance compared to matched controls remains the same in the majority of performance metrics including ERA, WHIP, WAR, and OPS. Post-operatively, pitchers with a UCLR prior to ulnar nerve transposition/decompression performed the same as matched controls with prior UCLR.

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