Anatomic Study on Anterior Transposition of the Vascularized Ulnar Nerve for Cubital Tunnel Syndrome

Objective To provide the anatomic basis for treatment of cubital syndrome in clinic with anterior transposition keeping the blood supply of the ulnar by observations of the ulnar nerve blood supply in the tube of elbow.Methods 30 adult cadaver upper limb specimen were injected with red-colored latex:the vascularity of the ulnar nerve was observed and external diameter and length were measured;And the clinical surgical procedure was imitated to measure maximum distance of tension-free anterior transposition of the ulnar nerve keeping the blood supply.Results There are three major arteries to supply the ulnar nerve at the cubital tunnel:the superior ulnar collateral artery,the inferior ulnar collateral artery and the posterior ulnar recurrent artery.The external diameter of the arteres at the beginning spot were 1.6±0.4 mm,1.2±0.4 mm and 1.5±0.8 mm respectively.And the total length of the vessels travelling alone with the ulnar nerve were 15.7±2.1 cm,5.0±0.9 cm and 5.9±1.1 cm respectively.The distances from arterial origin to the medial epicondyle were 15.0±1.3 cm,4.5±1.1 cm and 5.0±1.2 cm respectively.When imitating anterior transposition keeping the blood supply of the ulnar,the length of the ulnar keeping the blood supply should be 12.6±1.9 cm,and the distance of tension-free anterior transposition was 1.8±0.6 cm.Conclusion It is feasible to perform anterior transposition of the ulnar nerve accompanied with arteries for cubital tunnel syndrome.The average length of the ulnar keeping the blood supply should be 12.2 cm,and the average distance of tension-free anterior transposition was 1.8 cm.