Functional outcomes in young, active duty, military personnel after submuscular ulnar nerve transposition

Purpose The purpose of this study was to report on the results of submuscular ulnar nerve transposition (SMUNT) for treatment of cubital tunnel syndrome in a young, active duty, military population. Methods Twenty patients (20 extremities) were evaluated retrospectively a minimum of 12 months after surgery. Outcome analyses were performed using the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire and the Bishop-Kleinman rating scales, physical examination, return-to-work analysis, evaluation of complication rate, and overall patient satisfaction. Results At an average follow-up evaluation of 24 months (range, 12-38 mo), 19 patients had returned to full military active duty work status. The average duration of limited work capacity after surgery was 4.8 months (range, 3-7 mo). The DASH scores improved from an average of 32.5 points before surgery to 6.2 points after surgery. In 19 patients the functional outcome evaluated with the Bishop-Kleinman rating system was excellent. There were no poor outcomes using this rating score. Statistically significant improvements in both key pinch and grip strength were noted. Complications included one permanent and 2 transient neuropraxias of the medial antebrachial cutaneous nerve. Overall 19 of 20 patients were satisfied with the procedure and would have the surgery again if required. Conclusions Submuscular ulnar nerve transposition for cubital tunnel syndrome provides a reliable rate of return to full active duty work in military personnel with good patient satisfaction and minimal complications.