Medial epicondylectomy for ulnar palsy.

Abstract

N 'EUROPATHIES of the ulnar nerve at the elbow produced by traction, compression, or percussion of the nerve against the unyielding medial epicondyle require treatment to eliminate the harmful nerve-bone relationship. The currently popular procedure is to transplant the ulnar nerve to some site on the flexor side of the medial epicondyle. All transplantation operations require exposure of a considerable length of the nerve, with risk to its branches, merely to transfer the nerve to the other side of a bony prominence which itself has no important function. In its new location, the nerve lies subcutaneously in an artificial bed or in traumatized muscle where fibrosis, cicatricial ischemia, angulation against the edge of the intermuscuiar septum, or traction in elbow extension may produce further interference with its function. King and Morgan ~2 pointed out 28 years ago the logic of removing the offending medial epicondyle, as one would a tumor or foreign body, to permit the nerve to find its own optimal position. We are now reporting our experience with 14 patients treated by King and Morgan's medial epicondylectomy. We believe this method gives results superior to anterior transposition operations.