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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Median Nerve Motor Branch Transfer for Treatment of Severe Cubital Tunnel Syndrome

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  • presenting/speaker Li Wang - Third Hospital of Hebei Medical University, Shijiazhuang, China
  • Xinzhong Shao - Third Hospital of Hebei Medical University, Shijiazhuang, China
  • Zhemin Zhang - Third Hospital of Hebei Medical University, Shijiazhuang, China
  • Li Lv - Third Hospital of Hebei Medical University, Shijiazhuang, China
  • Wenxu Duan - Third Hospital of Hebei Medical University, Shijiazhuang, China
  • Fengyu Wang - Third Hospital of Hebei Medical University, Shijiazhuang, China

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1251

doi: 10.3205/19ifssh1211, urn:nbn:de:0183-19ifssh12115

Published: February 6, 2020

© 2020 Wang et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: This study aimed to present a modified method for treatment of severe cubital tunnel syndrome (CuTS), using ulnar nerve anterior subfascial transposition and an additional median nerve motor branch transfer to ulnar nerve

Methods: From May 2013 to October 2016, 41 patients with grade III CuTS based on McGowan's classification were enrolled. All patients were treated with same procedure: 1. ulnar nerve neurolysis and anterior subfascial transposition at the elbow, 2. median nerve motor branch of pronator quadratus transfer to motor branch of ulnar nerve at the forearm. Patients were followed at 3, 6, 9, 12 months postoperation. All patients underwent preoperative and final follow-up assessments of Disabilities of the Arm, Shoulder, and Hand (DASH) score, nerve conduction velocity (NCV), 2-point discrimination, and pinch and grip strength. The mean follow-up time was 33 months using the Modified Bishop scores system.

Results and Conclusions: At the final follow-up, the average DASH score, NCV, 2-point discrimination, and grip and pinch strengths improved in all patients. At least a 1-McGowan grade improvement was achieved in 37 patients (90.2%). According to the modified Bishop scores, 34 patients (82.9%) achieved good or excellent outcomes, 5 patients achieved fair outcomes (12.3%) and 2 patients (4.8%) had poor outcomes.

The modified method using ulnar nerve anterior subfascial transposition and an additional median nerve motor branch transfer to ulnar nerve, is a reliable and safe treatment option for treatment of patients with McGowan grade III severe CuTS, with satisfactory mid-to-long term functional and patient-rated outcomes.