A 33-year-old Chinese man presented with grade 4 (Medical Research Council) weakness of the abductor digiti minimi and first dorsalis interosseous muscles. There was split fourth finger innervation with hyposensitivity to superficial touch and pin-prick. Nerve conduction study (NCS) revealed right ulnar neuropathy. An inching study showed focal slowing 2 cm proximal to the medial epicondyle. On surgical exploration, the operative findings revealed subluxating right ulnar nerve with nerve scarring around the medial epicondyle. The flexor carpi ulnaris branches were identified and preserved. The medial intermuscular septum, arcade of Struthers, and Osborne ligament were released. The nerve was thus freed and transposed anteriorly and held in place with a fascial sling raised from the common flexor origin.
展开▼
