In-situ neurolysis is superior to nerve transposition and epicondylectomy in a rabbit model of ulnar nerve neuropathy

Fragestellung There are three main surgical techniques for ulnar nerve release, in- situ neurolysis (i), submuscular nerve transposition (ii) and epicondylectomy (iii). We aimed to investigate in a rabbit model the influence of mechanical distraction on the ulnar nerve on the functional and morphologic integrity.

Methodik In 42 rabbits the ulnar nerve was exposed and attached to the soft tissues using sutures leading to reproducible scarring of the nerve in this area, subsequently, the surgical techniques were performed. The measurements were conducted post-surgery and after four weeks to evaluate the short and long term effects. For all experimental groups, the strains in the non-joint and joint regions, measurement of nerve conduction velocity (NCV) using a miniaturized electric stimulator were performed and compared. Cristal Fast blue was used for tracing of the spinal ganglion perikarya and motoneurons.

Ergebnisse und Schlussfolgerung After neurolysis, there was only a slight drop in mean NCV, and no significant difference in the nerve cell count. After submuscular transposition and after epicondylectomy a moderate drop of NCV and a significantly lower level of nerve cells were detected. The scarred ulnar nerve four weeks after neurolysis showed was no difference in the overall strain and in strain distribution but after nerve transposition and epicondylectomy there was a highly significant change in the tensile properties in the joint- area.

In-situ neurolysis of the scarred ulnar nerve is less invasive and does not affect the electrophysiologic, biomechanical and cellular properties as transposition or epicondylectomy.

Stichwörter Elbow;Ulnar Nerve;Neurolysis;Fixator;submuscular transposition;nerve release

Publication History

Article published online:
15 October 2020