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Anterior Transposition in Cubital Tunnel Syndrome

  • Joseph Said
  • Asif M. IlyasEmail author
Chapter

Abstract

Anterior transposition for cubital tunnel syndrome consists of the surgical decompression of the ulnar nerve followed by movement of the nerve anterior to its native retrocondylar location relative to the medial epicondyle. Three different types of anterior transposition have been described, including subcutaneous, intramuscular, and submuscular transpositions. These procedures were developed to not only decompress the ulnar nerve but also to reduce nerve traction during elbow flexion that is not addressed by in situ ulnar nerve decompression alone. However, transposition procedures may pose a greater risk of complications (Macadam SA, Gandhi R, Bezuhly M, Lefaivre KA, J Hand Surg Am 33:1314.e1–12, 2008; Zlowodzki M, Chan S, Bhandari M, Kalliainen L, Schubert W, J Bone Joint Surg Am 89:2591–2598, 2007; Staples R, London DA, Dardas AZ, Goldfarb CA, Calfee RP, J Hand Surg Am 43:207–213, 2018; Zhang D, Earp BE, Blazar P, J Hand Surg Am 42:294.e1–294.e5, 2017). Evidence for the superiority of in situ decompression vs transposition and the type of transposition is lacking. Rather, surgeons may choose to perform an ulnar nerve transposition based on specific clinical settings or simply surgical preference. The goals of this chapter are to define various indications for anterior transposition, to outline controversies regarding in situ ulnar nerve decompression vs anterior transposition, to describe operative techniques, and to report outcomes comparing transposition procedures and in situ decompression.

Keywords

Anterior transposition Submuscular transposition Subcutaneous transposition Intramuscular transposition Subluxation Dislocation 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Summit Medical GroupWestfieldUSA
  2. 2.Rothman Orthopaedic InstitutePhiladelphiaUSA
  3. 3.Thomas Jefferson UniversityPhiladelphiaUSA

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