Treatment of compression neuropathy of the ulnar nerve at the elbow by epicondylectomy and neurolysis

Abstract

Compression neuropathy of the ulnar nerve at the elbow is treated by neurolysis and excision of the medial humeral epicondyle without transposing the ulnar nerve anteriorly. Removal of the medial humeral epicondyle is not associated with loss of motion at the elbow or reduction in strength of finger or wrist flexion because of the multiple muscle origins, as well as the firm healing of the common flexor origin to the resected bone surface. Thirty cases were treated between 1965 and 1977. Treatment halted progression of the disease in all patients. Discomfort and pain subsided in every instance. All 12 of the grade 1 patients had return of normal nerve function. Four of the 12 grade II patients were left with some weakness. Four of the six grade III patients improved to grade II status. None required secondary procedures on the ulnar nerve.