• Ronald H M A Bartels, Wim I M Verhagen, Gert Jan van der Wilt, Jan Meulstee, Leo G M van Rossum, and J André Grotenhuis.
• Department of Neurosurgery, University Medical Center St. Radboud, Nijmegen, The Netherlands. r.bartels@nch.umcn.nl
• Neurosurgery. 2005 Mar 1; 56 (3): 522-30; discussion 522-30.

ObjectiveThe main objective of this study was to compare the clinical outcome of participants treated by simple decompression (SD) of the ulnar nerve versus anterior subcutaneous transposition (AST).MethodsA prospective randomized controlled study was performed. Three hundred forty participants were referred to our institution between March 1999 and July 2002. One hundred fifty-two patients met the inclusion criteria and were randomized into two surgical groups: 75 were assigned to SD, and 77 were assigned to AST. Participants were followed for 1 year after surgery. The main outcome measure was clinical outcome 1 year after surgery.ResultsAn excellent or good result was obtained in 49 of 75 participants who underwent SD and in 54 of 77 participants undergoing AST. The difference was not statistically significant. However, the complication rate was statistically lower in the SD group (9.6%) compared with the AST group (31.1%) (risk ratio, 0.32; 95% confidence interval, 0.14-0.69). Duration of symptoms, (sub)luxation of the ulnar nerve, and severity of the complaints did not influence outcome.ConclusionSurgery for ulnar neuropathy at the elbow is effective. The outcomes of SD and AST are equivalent, except for the complication rate. Because the intervention is simpler and associated with fewer complications, SD is advised, even in the presence of (sub)luxation.

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