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Compressive ulnar neuropathies at the elbow: II. treatment

New York University School of Medicine, New York, NY and New York University/Hospital for Joint Diseases Department of Orthopaedic Surgery and Lenox Hill Hospital, New York, USA.

Initial treatment of most compressive neuropathies at the elbow is nonoperative, consisting of rest, avoidance of elbow flexion, and, when necessary, temporary immobilization of the elbow and wrist. If symptoms persist, particularly when accompanied by muscle weakness, surgery is usually indicated. Operative procedures include decompression without transposition of the nerve (in situ or by means of medial epicondylectomy) and decompression with transposition of the nerve carried out in a subcutaneous, intramuscular, or submuscular fashion. The indications, advantages, disadvantages, and surgical technique of each operative procedure are discussed.