Endoscopically Assisted Anterior Subcutaneous Transposition of Ulnar Nerve  Tun Hing Lui, M.B.B.S.(HK), F.R.C.S.(Edin), F.H.K.A.M., F.H.K.C.O.S.  Arthroscopy Techniques  Volume 5, Issue 3, Pages e643-e647 (June 2016) DOI: 10.1016/j.eats.2016.02.010 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 Endoscopically assisted anterior subcutaneous transposition of the left ulnar nerve. (A) A 3- to 4-cm incision is made posterior to the medial humeral epicondyle and close to the olecranon. The cubital tunnel retinaculum (arcuate ligament) and the flexor pronator retinaculum between the 2 heads of flexor carpi ulnaris are released. (B) The ulnar nerve is mobilized and held with a vascular sling. Arthroscopy Techniques 2016 5, e643-e647DOI: (10.1016/j.eats.2016.02.010) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 Endoscopically assisted anterior subcutaneous transposition of the left ulnar nerve (UN). (A) The subcutaneous layer is elevated from the deep fascia covering the ulnar nerve by means of a Deaver retractor. (B) The ulnar nerve is traced proximally and the overlying deep fascia is released under endoscopic guidance with an endoscopic scissors. Arthroscopy Techniques 2016 5, e643-e647DOI: (10.1016/j.eats.2016.02.010) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 Endoscopically assisted anterior subcutaneous transposition of the left ulnar nerve (UN). The arcade of Struthers (AS) can be identified and released with an endoscopic scissors. Arthroscopy Techniques 2016 5, e643-e647DOI: (10.1016/j.eats.2016.02.010) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 4 Endoscopically assisted anterior subcutaneous transposition of the left ulnar nerve. The medial intermuscular septum (IS) can be identified as a tough structure anterior to the ulnar nerve (UN) and posterior to the muscles of the anterior compartment (ACM). Release of the medial intermuscular septum is from distal proximally. Arthroscopy Techniques 2016 5, e643-e647DOI: (10.1016/j.eats.2016.02.010) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 5 Endoscopically assisted anterior subcutaneous transposition of the left ulnar nerve (UN). (A) When the nerve is fully mobilized and can be transposed anteriorly without any kink, (B) the nerve is stabilized in the anterior subcutaneous pouch by suturing the subcutaneous tissue to the pronator-flexor origin. (C) After anterior transposition, the ulnar nerve lies within the subcutaneous bed. Arthroscopy Techniques 2016 5, e643-e647DOI: (10.1016/j.eats.2016.02.010) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions