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Khirurgii

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Year 2016 Vol. 24 No 3

TRAUMATOLOGY & ORTHOPEDICS

N.I. KHVISYUK1, S.A. GOLOBOROD’KO1, S.K. RAMALDANOV2

ULTRASOUND DIAGNOSIS AFTER ANTERIOR SUBCUTANEOUS TRANSPOSITION OF THE ULNAR NERVE

Kharkov Medical Academy of Postgraduate Education1,
Kharkov Regional Traumatological Hospital2,
Kharkov, Ukraine

Objectives. To confirm the absence of dislocation of the ulnar nerve after its anterior subcutaneous transposition.
Methods. Diagnostic ultrasonographic examination of the ulnar nerve after subcutaneous anterior transposition in patients (n=9) had been carried out. There were 4 females and 5 males in the studied group; the average age was 42 years (ranging 25-59 years). The transposition of the ulnar nerve was performed on one right and on eight left upper extremities: in 8 patients with cubital tunnel syndrome and in 1 with old injury of the ulnar nerve. Ultrasonography was performed in all patients after 16 months in average (from 6 to 25) after surgery.
For prevention of dislocation of the ulnar nerve after its subcutane­ous transposition the method of fixation of the ulnar nerve had been worked out. The longitudinal undulating incision with length of 12-14 cm was performed. The top of one of the “waves” section should be turned laterally and placed 1,5-2 cm laterally from the apex of the medial epicondyle of the humerus. After transposition of the nerve in the forearm fascia in the longitudinal direction C-shaped incision that form and location coincides with the peak of the “waves” of skin incision was carried out. In the area of the top “waves” 3-4 vertical mattress skin-subcutaneous-fascial sutures had been imposed.
Diagnostic ultrasonographic examination was performed on an ultrasound diagnostic apparatus Philips HD7 (Austria) with the using of a L 12-3 MHz linear array transducer.
Results. The analysis of transverse and longitudinal ultrasound scannings in all operated patients (n=9) in extension, flexion and upon attempt of forcible displacement of the ulnar nerve the skin-subcutaneous-fascial block scar reliably held the ulnar nerve in the anterior subcutaneous transposition.
Conclusion. Ultrasonographic examination permits to confirm objectively the absence of dislocation of the ulnar nerve after anterior subcutaneous transposition.

Keywords: cubital tunnel syndrome, dislocation of the ulnar nerve, operative treatment, recurrence, ultrasonography, anterior subcutaneous transposition of the ulnar nerve
p. 265-268 of the original issue
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Address for correspondence:
61178, Ukraine,
Kharkov, Saltovskoe shosse
d. 266, korpus V,
Harkovskaya oblastnaya
klinicheskaya travmatologicheskaya bolnitsa,
kafedra kombustiologii,
rekonstruktivnoy i plasticheskoy khirurgii
e-mail: golosa@ukr.net,
Goloborod’ko Sergey Anatolevich
Information about the authors:
Khvisyuk N.I. MD, professor of the chair of traumatology, anesthesiology and military medicine of Kharkov Medical Academy of Postgraduate Education. Ukraine.
Goloborod’ko S.A. PhD, an associate professor of the chair of combustiology, reconstructive and plastic surgery of Kharkov Medical Academy of Postgraduate Education. Ukraine.
Ramaldanov S.K. PhD, a physician of Kharkov Regional Clinical Traumatological Hospital. Ukraine.
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