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Background:Surgical decompression of the ulnar nerve is effective for cubital tunnel syndrome.However,deep approaches may result in iatrogenic elbow stiffness.This long-term study was to evaluate the range of motion (ROM) of the elbow and functional outcomes after anterior subcutaneous transposition.Methods:A total of 115 patients (78 male and 37 female;mean age:46.6 years) who underwent anterior subcutaneous transposition of the ulnar nerve between 2001 and 2005 were evaluated retrospectively;mean follow-up was 13.5 years.Elbow ROM was measured as flexion arc,flexion,and extension preoperatively and at the final follow-up,and compared via a mixed analysis of variance adjusting for age.Neuropathy was assessed preoperatively using a modified McGowan neuropathy grade and postoperatively using modified Wilson-Krout criteria.An ordinal logistic regression analysis used postoperative modified Wilson-Krout criteria as the outcome and preoperative factors as predictors.Results:Preoperative McGowan grades were Grade 1 in 14 patients (12.2％),Grade 2A in 28 (24.3％),Grade 2B in 53 (46.1％),and Grade 3 in 20 (17.4％) patients.Postoperatively,66 patients (57.4％) had excellent results,26 (22.6％) had good results,16 (13.9％) had fair results,and 7 (6.1％) had poor results at the final follow-up,as per the Wilson-Krout criteria.There were no complications.Pre-and postoperative elbow ROM was significantly decreased in patients with previous trauma or surgery of the elbow compared with those without (P ＜ 0.05).Anterior subcutaneous transposition of the ulnar nerve did not significantly affect elbow ROM regardless of previous trauma or surgical history nor preoperative ROM (P ＞ 0.05),after adjusting for age.Patients with prolonged symptoms prior to surgery and worse neuropathy tended to have less satisfactory functional outcomes (P ＜ 0.05),after adjusting for covariates.Conclusions:Anterior subcutaneous transposition of the ulnar nerve is an effective and reliable treatment of cubital tunnel syndrome with satisfactory outcomes and minimal effect on elbow ROM.