Transmuscular Ulnar Nerve Transposition in a Case of Traumatic Medial Cord Injury 1 Mackinnon SE1 Yee A1 August 23, 2013Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.Cubital tunnel syndrome can present with pain/numbness in the ulnar nerve territory and weakness in the ulnar-innervated extrinsic/intrinsic muscles. The etiology for cubital tunnel syndrome depends on the case and includes various points of compression along the course of the ulnar nerve. The most common compression point is the medial epicondyle at which the fascial leading-edge of the flexor carpi ulnaris and the aponeurosis superficial to the cubital tunnel compress the nerve. However other compressive points can exist and can be under-recognized. The transmuscular ulnar nerve transposition (TUNT) addresses these compressive points by releasing and transposing the nerve through a transmuscular bed within the pronator-flexor muscle bundle. In this case, the patient had a traumatic medial cord injury and presented 1-year following with associated ulnar neuropathy and fibrillations/motor unit potentials. The TUNT was elected with a supercharge anterior interosseous to ulnar motor nerve transfer, Guyon's canal release, and FDP tenodesis. This video highlights details of the TUNT.Keywords: ulnar nerve transpositioncubital tunnel syndrometransmuscular transpositioncompression neuropathyulnar nervenerve decompression You must login to view the full article and extended video on this page. Standard Edition Table of Contents- Slow down- Frustration00:00:00 - Introduction00:00:15 - Orientation / Incision / Exposure00:00:40 - Identifying the Medial Antebrachial Cutaneous Nerve00:01:20 - Exposing the Medial Epicondyle and Common Flexor Tendon00:01:56 - Identifying the Ulnar Nerve and Releasing the Cubital Tunnel Aponeurosis00:02:12 - Creating the Medial and Lateral Fascial Tendon Step-Lengthening Flaps00:03:22 - Resecting the Fascial Septum “T” between the Pronator-Flexor Muscle Bundle00:04:05 - Resecting the Medial Intermuscular Septum00:04:49 - Resecting the Distal Intermuscular Septum00:05:35 - Releasing the Aponeurosis of Flexor Carpi Ulnaris and Transverse Vessels00:05:50 - Sliding the Deep Pronator-Flexor Muscle Origin00:06:04 - Releasing the Intermuscular Septum00:06:47 - Neurolyzing the Flexor Carpi Ulnaris Branch from the Ulnar Nerve00:07:23 - Creating the Transmuscular Bed00:07:47 - Transmuscular Ulnar Nerve Transposition00:09:02 - Checking Compression through the Arcade of Struthers You must login to view the full article and extended video on this page. Leave a Comment Cancel replyYou must be logged in to post a comment.