{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T23:53:54Z","timestamp":1778198034529,"version":"3.51.4"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T00:00:00Z","timestamp":1738108800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>Cubital tunnel syndrome is a common peripheral neuropathy of the upper extremity. Anterior transposition of the ulnar nerve is an established surgical treatment option for this condition. This study aimed to introduce a novel musculofascial lengthening technique that uses only a portion of the flexor-pronator muscle mass for submuscular anterior transposition of the ulnar nerve and investigate its clinical outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We evaluated 28 patients (29 cases; 1 patient had bilateral involvement) diagnosed with cubital tunnel syndrome who were treated with surgical decompression and submuscular anterior transposition of the ulnar nerve using our novel technique. Mean follow-up was 19.1 months (range, 12\u201331). Patient-reported outcomes were assessed using the Boston Carpal Tunnel Questionnaire (BCTQ), Disabilities of the Arm, Shoulder, and Hand (DASH) Questionnaire, and numeric rating scale (NRS) for pain. Objective outcomes including light touch perception, static two-point discrimination, and grip strength were also assessed. Modified Bishop score and postoperative complications were also evaluated.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>BCTQ symptom severity and functional status scores, DASH score, and NRS for pain score showed significant improvement after surgery. Light touch perception, static two-point discrimination, and grip strength also significantly improved after surgery. All patients showed excellent or good results according to the modified Bishop scoring system. No recurrence or complications occurred.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Our novel musculofascial lengthening technique that uses only a portion of the flexor-pronator muscle mass for submuscular anterior transposition of the ulnar nerve reliably achieves good results with minimal complications in patients with cubital tunnel syndrome.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0318303","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T18:26:26Z","timestamp":1738175186000},"page":"e0318303","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Modified musculofascial lengthening technique for submuscular ulnar nerve transposition in cubital tunnel syndrome"],"prefix":"10.1371","volume":"20","author":[{"given":"Sang-Pil","family":"So","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0587-5183","authenticated-orcid":true,"given":"Won Sun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1926-3228","authenticated-orcid":true,"given":"KiHyeok","family":"Ku","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young Ho","family":"Shin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5104-4634","authenticated-orcid":true,"given":"Jae Kwang","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,1,29]]},"reference":[{"issue":"2","key":"pone.0318303.ref001","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1055\/s-0031-1271800","article-title":"Cubital tunnel syndrome\u2014a review and management guidelines","volume":"72","author":"H Assmus","year":"2011","journal-title":"Cent Eur Neurosurg"},{"issue":"1\u20132","key":"pone.0318303.ref002","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.jns.2005.02.010","article-title":"Incidence of ulnar neuropathy at the elbow in the province of Siena (Italy)","volume":"234","author":"M Mondelli","year":"2005","journal-title":"J Neurol Sci"},{"issue":"1","key":"pone.0318303.ref003","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/S0363-5023(09)91100-5","article-title":"Medial epicondylectomy for the treatment of ulnar nerve compression at the elbow","volume":"15","author":"SJ Heithoff","year":"1990","journal-title":"J Hand Surg Am"},{"issue":"6","key":"pone.0318303.ref004","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1227\/00006123-198012000-00001","article-title":"Ulnar neuropathy at the elbow: comparison of simple decompression and anterior transposition","volume":"7","author":"RC Chan","year":"1980","journal-title":"Neurosurgery"},{"issue":"4","key":"pone.0318303.ref005","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/S0266-7681(05)80151-2","article-title":"Anterior submuscular transposition of the ulnar nerve for cubital tunnel syndrome","volume":"20","author":"CB Pasque","year":"1995","journal-title":"J Hand Surg Br"},{"issue":"4","key":"pone.0318303.ref006","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/j.jse.2009.10.014","article-title":"Comparative study of surgical treatment of ulnar nerve compression at the elbow","volume":"19","author":"GI Mitsionis","year":"2010","journal-title":"J Shoulder Elbow Surg"},{"issue":"6","key":"pone.0318303.ref007","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/0363-5023(94)90091-4","article-title":"Intraneural ulnar nerve pressure changes related to operative techniques for cubital tunnel decompression","volume":"19","author":"AL Dellon","year":"1994","journal-title":"J Hand Surg Am"},{"issue":"Suppl 1","key":"pone.0318303.ref008","doi-asserted-by":"crossref","first-page":"169","DOI":"10.2106\/00004623-200409001-00007","article-title":"Results of the musculofascial lengthening technique for submuscular transposition of the ulnar nerve at the elbow","volume":"86-A","author":"AL Dellon","year":"2004","journal-title":"J Bone Joint Surg Am"},{"issue":"1","key":"pone.0318303.ref009","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/S0363-5023(05)80192-3","article-title":"Ulnar nerve decompression by transposing the nerve and Z-lengthening the flexor-pronator mass: clinical outcome","volume":"22","author":"R Nouhan","year":"1997","journal-title":"J Hand Surg Am"},{"issue":"7","key":"pone.0318303.ref010","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1302\/0301-620X.86B7.14877","article-title":"Anterior submuscular transposition of the ulnar nerve. 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