[Results of the surgical treatment of ulnar nerve neuropathy in the elbow area].

Osborne's decompression operation is used only in selected cases of cubital tunnel syndrome, where compression is obviously caused by the aponeurotic arch between the heads of flexor carpi ulnaris. In all the other cases, when there is subluxation or chronic dislocation of the nerve over the medial epicondyle, when there are adhesions in the postcondylar groove, when any other local cause or no cause at all is found, anterior transposition is preferred. More and more often we tend to use a subcutaneous transposition except in those cases where kinking would be unavoidable due to hypertrophy of flexor muscles. Epicondylectomy has been employed only in a few instances of pseudarthrosis of the medial epicondyle combined with ulnar palsy. Subluxation or dislocation of the ulnar nerve has been found in our series in 36,5% of 338 cases, which is more than indicated by Childress for a normal population (16%) and more than indicated in most reports of operated cases. This may be due to the fact that we pay particular attention to subluxation, finding it at operation in many cases where the subluxation could not be demonstrated clinically. Other abnormalities encountered were: hypertrophy of the medial head of triceps (15%); an ulnar nerve buried in the triceps muscle (3%); abnormal septa inserting into the medial intermuscular septum and constricting the nerve (1%); an epitrochleo-anconaeal muscle in 31 cases (9%), less often than indicated by Mumenthaler as being the normal frequency (20%). The aponeurotic arch between the heads of flexor carpi ulnaris was missing in 5% of cases. With the techniques advocated, improvement and healing occurred subjectively in 78%, clinically in 92%, and neurographically in 63,5% of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)