Submuscular transposition of the ulnar nerve

A retrospective study of 26 submuscular ulnar nerve transpositions was performed with the specific use of grip and pinch analysis to evaluate this form of objective testing. Twenty-six patients were treated by submuscular transposition of the ulnar nerve between 1981 and 1985 and were followed an average of 21 months. Preoperative and postoperative analysis consisted of subjective questioning, clinical examination, quantitative two-point discrimination, quantitative pinch and grip analysis, and electromyographic (EMG) and nerve conduction velocity (NCV) evaluation. Many of the patients suffered from associated problems such as alcohol abuse, diabetes mellitus, and concurrent Guyon's canal compression, which adversely affected the outcome. Subjectively, 62% were improved, 31% were no better, and 7% were worse. Clinical examination demonstrated 46% improved, 35% no better, and 19% worse. Quantitative two-point discrimination was better in 59%, unchanged in 26%, and worse in 15%. Quantitative pinch and grip analysis revealed 28% improved, 56% with little improvement, or the same, and 16% worse, while EMG/NCV showed one-third of the patients in each category postoperatively. Quantitative pinch and grip analysis provided good preoperative and postoperative documentation, which is absent from previous studies in the literature concerning ulnar nerve transportation.