Left Elbow Ulnar Nerve Decompression and Transposition

Description

This video features a surgical demonstration by Dr. Daniel Osei, a hand surgeon at the Hospital for Special Surgery, focusing on the ulnar nerve transposition procedure. The video begins with an introduction to the anatomy of the elbow, specifically the medial epicondyle and the path of the ulnar nerve. Dr. Osei explains the importance of using an anterior incision for better access and visualization of the nerve. He meticulously describes the surgical steps, emphasizing the significance of preserving small cutaneous nerves to avoid sensory loss and persistent pain.



Throughout the procedure, Dr. Osei highlights various anatomical structures, including the medial intermuscular septum, the flexor carpi ulnaris (FCU), and Osborne's ligament, noting how they relate to potential sources of nerve compression. He demonstrates techniques for dissecting the nerve carefully and decompressing it to alleviate symptoms associated with ulnar nerve entrapment. Additionally, the video discusses the importance of ensuring that the nerve is well-positioned and free from tension after transposition, especially with the elbow in extension to prevent recurrent symptoms.



The surgical technique includes the use of a subcutaneous flap to anchor the transposed nerve securely, ensuring it does not revert to its previous position. The procedure concludes with a focus on achieving hemostasis and preparing for patient recovery, underscoring the goal of restoring nerve function and dexterity for the patient's long-term wellbeing.

Specialties