61 patients with a distal humerus fracture and scheduled for plate fixation were randomized with either ulnar nerve decompression, or anterior transposition of the ulnar nerve during surgery. The purpose of this study was to compare elbow function measures and clinical outcomes between groups over a 2-year follow-up. Only results up to 1 year were reported. No significant differences between groups were observed for any outcome measure, including the Ulnar Nerve Entrapment Score classification, Mayo Elbow Performance Score, and the two-point discrimination test. Significant improvement from baseline to 1 year was observed within the entire study population.