Subcutaneous Ulnar Nerve Transposition

1. Introduction and Surgical Approach

2. Incision

3. Superficial Dissection

4. Identify and Preserve Medial Antebrachial Cutaneous Nerve

5. Ulnar Nerve Dissection

1. Identify Ulnar Nerve and Examine Movement
2. Start Dissection Posterior to the Medial Epicondyle
3. Mobilize Nerve Circumferentially
4. Mobilize Nerve Distally and then Proximally
5. Transpose Ulnar Nerve Anteriorly and Complete Dissection Posteriorly
6. Release First Branch to the FCU if Necessary
7. Complete Dissection Distally Between the Two Heads of the FCU

6. Release Intermuscular Septum

7. Cubital Tunnel Closure

8. Subcutaneous Transposition

1. Mark for Submuscular Transposition with Z-Lengthening
2. Raise Posterior Limb to Form Fascial Sling
3. Close Fascial Sling to Anterior Skin Flap Subcutaneous Tissue to Secure Ulnar Nerve

9. Assessment of Stability and Tension

10. Closure