Anterior interosseous nerve transfer combined with cubital and ulnar tunnel release for severe ulnar nerve compression

Introduction: We investigated the outcomes of patients with severe ulnar nerve compression who underwent anterior interosseous nerve transfer combined with cubital and ulnar tunnel release. Methods: Twenty-eight patients with McGowan IIB or III ulnar neuropathy caused by compression and with compound muscle action potentials of the ulnar intrinsics less than 3 mV were prospectively recruited for outcome analysis. Clinical signs of ulnar palsy, two-point discrimination tests, gripping and pinching force and electrophysiological studies were recorded over a 2 year follow-up. Results: Significant improvement was observed in most features by 6 months after surgery. Subgroup analysis by aetiology at 2 years revealed no statistically significant differences in the recorded variables between individuals with previous trauma and those with idiopathic ulnar palsy. Conclusion: Anterior interosseous nerve transfer, along with cubital and ulnar tunnel release, results in sustained clinical and electrophysiological improvements in patients with severe chronic ulnar nerve compression, which encourages its adoption as a standard treatment for severe chronic ulnar nerve compression. Level of evidence: IV