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A little research into Ulnar Nerve Transposition

Being in PT school, things like this surgery really intrigue me.  So, I decided to do a little digging into the literature to see what the outcomes are for this particular surgery.  I did my digging through my schools ebscohost search engine, using CINAHL and MEDLINE, if any of you have access to those resources and would like to check out the articles.  I don't think that they will be available for everyone though.

"Postoperative Clinical Results in Cubital Tunnel Syndrome" -  This is an article published in the Orthopedics Journal in April 2006.  In this study, they followed 111 operated limbs, all of which had the same, or similar, procedure that Pujols had.  The procedures included medial epicondylectomy on 66 limbs, anterior transposition on 41 limbs, and simple decompression on 4 limbs.  Of these, 13 limbs were operated on for habitual dislocation, which appears to be the reason Albert had his surgery according to the Goold article.  Also, from what I gathered in the Goold article, Pujols underwent the anterior transposition procedure.

postoperative results at the final evaluation were excellent in 37 limbs, good in 39 limbs, fair in 26 limbs, and poor in 9 limbs.
Age was a factor in the results of this study, with a correlation between age at surgery and results of the surgery.  The younger the patient, the better the outcome. 

There was no difference found in this study for the reason the patients had the surgery, or for the procedure they underwent.

FWIW, this study doesn't really reveal much, if anything regarding my questions.  I went into this wanting to know :

  1.  What is the rate of success for the procedure Albert had
  2. Is that going to be as successful for the etiology (reason) of Albert's injury.
  3. What is the usual recovery time for this procedure

My opinion going into this project was that Goold's use of McClellan's operation breeds false hope.  My understanding is Pujols had a more involved procedure, whereas McClellan more than likely had the simple decompression procedure talked about in the article.  Then I found this article abstract from the Journal of Bone and Joint Surgery.  The most important thing I found was in the results: No difference between simple decompression and transposition was found.

I was unable to find anything on the time of recovery, but the timeline given by Goold seems to be along what I have learned so far.  Three weeks of rest, then begin to work on regaining strength and ROM.

Hope that my ramblings helped to shed some light on the subject!

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