The effect of in-situ decompression on ulnar nerve stability: a cadaveric study.

Ten fresh frozen right cadaver arms were placed in a motorized jig and an in-situ ulnar nerve decompression was performed in 5 mm increments distally to the flexor carpi ulnaris (FCU) aponeurosis then proximally to the intermuscular septum. The elbows were ranged 0-135° after each incremental decompression and the ulnar nerve to medial epicodyle distance was measured to assess for nerve translation/subluxation compared with baseline (prerelease) values. None of the specimens had ulnar nerve subluxation (defined as anterior translation past the medial epicondyle) even after full decompression. Furthermore, there were no statistically significant ulnar nerve translations (defined as any difference in distance from ulnar nerve to medial epicondyle before and after each decompression) for any flexion angle or extent of decompression. This study provides biomechanical evidence that in situ ulnar nerve decompression from the FCU aponeurosis to the intermuscular septum does not result in significant ulnar nerve translation or subluxation.

Splintage in the treatment of sagittal band incompetence and extensor tendon subluxation.

UNLABELLED: This study assessed the success of splintage for traumatic and atraumatic sagittal band incompetence and its relationship to the duration of symptoms before treatment. A retrospective review of all patients with sagittal band incompetence treated with splintage was performed. All patients had extensor tendon subluxation on physical examination. Ninety-two patients were included: 68 traumatic and 24 atraumatic. Subluxation resolved with splintage in 77 patients. Traumatic tendon subluxation resolved in 95% of acute injuries, 100% of subacute injuries, and 67% of chronic injures. Atraumatic tendon subluxation resolved in 100% of patients with acute presentation, 67% of patients with subacute presentation, and 57% of patients with chronic presentation. Surgery was rarely required. Splintage proved very effective for acute sagittal band incompetence, regardless of causation, but decreased in efficiency with chronicity. LEVEL OF EVIDENCE: Level 4.