Although there have been a series of publications from 1988 through 2000 that describe in detail the authors’ technique for submuscular transposition of the ulnar nerve utilizing the musculofascial lengthening technique, there have been just two studies published with the results of this technique. The study by Pasque and Rayan reported 31transpositions and that by Nouhamn and Kleinert reported 48 transpositions with this technique. The present study reports a consecutive series of 121 patients with 161 transpositions with this technique done from 1985 through 1991.

In addition to the patient history and physical examination, measurements of sensory and motor function were obtained prospectively to permit staging of the severity of the compression by means of a numerical grading scale. Non-parametric statistics were used to evaluate the pre- versus post-operative change in this scale. Each surgery was done by the same surgeon. The mean follow-up interval after surgery was 45.6 months.

Utilizing traditional criteria, excellent results were obtained in 65%, good results in 23%, fair results in 4% and recurrence or failure in 8% of this population.

Utilizing a numerical grading scale to evaluate the results, there was a statistically significant improvement in the ulnar nerve function regardless of whether sensory (p<.001) or motor (p<.00l) components were considered. This statistical approach facilitated comparison of clinical subgroups, demonstrating significant improvement in those patient's with diabetes, those with workmen's compensation claims, and those with a severe degree of compression versus a mild degree of compression.

It is concluded that the musculofascial lengthening technique is a predictable technique with a high percentage success in patients with moderate to severe degree of ulnar nerve compression at the elbow. It is also concluded that a numerical grading scale permits ease of statistical evaluation of the results of peripheral nerve surgery.