Failure of Ulnar Nerve Transposition at the Elbow 

This person had an ulnar nerve transposition several year ago with improvement of ulnar nerve signs and symptoms. He presents with new symptoms of ulnar neuropathy at the elbow. Nerve conduction studies reveal conduction block and focal slowing of motor and sensory fibers across the site of the transposition. Known osteoarthritis of the elbow. Multiple osteophytes noted on XR and ultrasound. This video shows how the nerve is anchored (tented) on the medial epicondyle. Note how the nerve takes a very oblique course just distal to the medial epicondyle following the path of the transposition. It was surgically placed between the humeral head of FCU and FDS instead of the normal course deep to the 2 heads of FCU. The first few frames show a few fasciculations in FCU not heard on needle EMG.