A retrospective study was conducted on 148 patients with ulnar neuropathy at the elbow, who underwent surgical treatment between 1981 and 1989.Of the 178 nerves operated on, 105 underwent subcutaneous anterior transposition, and 73 were decompressed without transposition. We compared the surgical results of these two groups, and factors influencing prognosis. Overall, 92% of patients improved postoperatively. Re-operatively, electrophysiological assessment corresponded well to clinical findings. and to macroscopic findings at operation in 95% of cases. The severity of pre-operative clinical findings, advancing age, duration of symptoms and the presence of intraneural fibrosis did not predict an adverse outcome. A satisfactory outcome in 72% of those decompressed compared with 60% of those who were transposed was not statistically significant. However, there was a lower percentage of those with unsatisfactory results in the decompressed series. Thus, we advise that, except where there is persistent deformity or a mass lesion in the region of the ulnar groove. decompression is the operation of choice.

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with a diagnosis of fracture of the odontoid process of the axis were reviewed. There were nine patients representing 20% of all new cervical fractures. The mean age was 64.5 i 19.3 years. Alcoholism, brain damage following head injury, osteo-arthritis, cervical spondylosis, rheumatoid arthritis and osteoporosis may be complicating factors in the management of odontoid fractures. A fracture of the odontoid in an elderly patient with a history of minimal trauma suggests osteoporosis. Early mobilization in a custom-moulded orthosis with frequent radiological monitoring prevents the complications of prolonged bed rest.