This journal is
indexed in Scopus

Year 2016 Vol. 24 No 3


DOI:   |  



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
  1. Caputo AE, Watson HK. Subcutaneous anterior transposition of the ulnar nerve for failed decompression of cubital tunnel syndrome. J Hand Surg Am. 2000 May;25(3):544-51.
  2. Huang W, Zhang PX, Peng Z, Xue F, Wang TB, Jiang BG. Anterior subcutaneous transposition of the ulnar nerve improves neurological function in patients with cubital tunnel syndrome. Neural Regen Res. 2015 Oct;10(10):1690-95. doi: 10.4103/1673-5374.167770.
  3. Palmer BA, Hughes TB. Cubital tunnel syndrome. J Hand Surg Am. 2010 Jan;35(1):153-63. doi: 10.1016/j.jhsa.2009.11.004.
  4. Spinner RJ. Nerve decompression. In: Morrey Bernard F, editor. The Elbow. 3rd ed. Philadelphia, US: Wolters Kluwer; 2015. p. 217-33.
  5. Xarchas KC, Psillakis I, Koukou O, Kazakos KJ, Ververidis A, Verettas DA. Ulnar nerve dislocation at the elbow: review of the literature and report of three cases. Open Orthop J. 2007;1:1-3. doi: 10.2174/1874325000701010001.
  6. Catalano LW 3rd, Barron OA. Anterior subcutaneous transposition of the ulnar nerve. Hand Clin. 2007 Aug;23(3):339-44, vi.
  7. Lequint T, Naito K, Awada T, Facca S, Liverneaux P. Ulnar nerve transposition using a mini-invasive approach: case series of 30 patients. J Hand Surg Eur. 2013 Jun;38(5):468-73. doi: 10.1177/1753193412456927.
  8. Goloborod'ko CA. Sposob fiksatsii loktevogo nerva posle ego podkozhnoi transpozitsii [A method of fixation of the ulnar nerve after subcutaneous transposition]. Ortopediia Travmatologiia i Protezirovanie. 2015;(1):79-82.
  9. Lima S, CorreiaI JF, Martins RM, AlvesI JM, Palheiras J, de Sousa C. Subcutaneous anterior transposition for treatment of cubital tunnel syndrome: is this method safe and effective? Rev Bras Ortop. 2012;47(6):748-53. doi: 10.1590/S0102-36162012000600013.
  10. Saltykova VG. Vysokorazreshaiushchee ul'trazvukovoe issledovanie loktevogo nerva v norme i pri razvitii sindroma kubital'nogo kanala [High-resolution ultrasound of the ulnar nerve in health and development of cubital tunnel syndrome]. Ul'trazvuk i Funkts Diagnostika. 2009;(6):61-74.
  11. Choi SJ, Ahn JH, Ryu DS, Kang CH, Jung SM, Park MS, et al. Ultrasonography for nerve compression syndromes of the upper extremity. Ultrasonography. 2015 Oct;34(4):275-91. doi: 10.14366/usg.14060.
  12. Kim JH, Won SJ, Rhee WI, Park HJ, Hong HM. Diagnostic cutoff value for ultrasonography in the ulnar neuropathy at the elbow. Ann Rehabil Med. 2015 Apr;39(2):170-5. doi: 10.5535/arm.2015.39.2.170.
  13. Kowalska B, Sudoł-Szopińska I. Ultrasound assessment on selected peripheral nerve pathologies. Part I: Entrapment neuropathies of the upper limb - excluding carpal tunnel syndrome. J Ultrason. 2012 Sep;12(50):307-18. doi: 10.15557/JoU.2012.0016.
  14. Chen H, Takemoto R. Application of ultrasound in an ulnar motor nerve conduction study after anterior ulnar nerve transposition. Ultrasound. 2012 Nov; 20(4):228-30. doi: 10.1258/ult.2012.012022.
  15. Vosbikian MM, Tarity TD, Nazarian LN, Ilyas AM. Does the ulnar nerve enlarge after surgical transposition? J Ultrasound Med. 2014 Sep;33(9):1647-52. doi: 10.7863/ultra.33.9.1647.
Address for correspondence:
61178, Ukraine,
Kharkov, Saltovskoe shosse
d. 266, korpus V,
Harkovskaya oblastnaya
klinicheskaya travmatologicheskaya bolnitsa,
kafedra kombustiologii,
rekonstruktivnoy i plasticheskoy khirurgii
Goloborodko 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.
Goloborodko 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.
Contacts | ©Vitebsk State Medical University, 2007