The Ulnar Nerve in Elbow Trauma

Shin, Robert; Ring, David

doi:10.2106/jbjs.f.00594

Cited by 71 publications

(41 citation statements)

References 71 publications

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“…Transposition of the ulnar nerve in elbow trauma is controversial because some authors recommend routine transposition whereas others do not. 38,43 In this series, no routine transposition of the ulnar nerve was performed.…”

Section: Discussionmentioning

confidence: 99%

“…23,27,30,31,38 Open anatomic reduction of the articular surface and stable internal fixation have been proposed as a standard treatment 16,19,27,38 to enable early postoperative mobilization and to restore a pain-free and satisfactory level of elbow function. 34 Several biomechanical studies indicate that double-plate osteosynthesis with 2 orthogonal plates may provide adequate fracture stabilization under in vitro and in vivo conditions.…”

mentioning

confidence: 99%

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Treatment of supra- and intra-articular fractures of the distal humerus with the LCP Distal Humerus Plate: a 2-year follow-up

Kaiser

Brunner

Hohendorff

et al. 2011

Journal of Shoulder and Elbow Surgery

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Treatment of supra- and intra-articular fractures of the distal humerus with the LCP Distal Humerus Plate: a 2-year follow-up

Kaiser

Brunner

Hohendorff

et al. 2011

Journal of Shoulder and Elbow Surgery

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“…1 With an estimated annual incidence of 75,000 cases in the United States, the health care and societal burden of ulnar neuropathy at the elbow continues to grow. 2 Similar to carpal tunnel syndrome, various stressors on the ulnar nerve result in pain, numbness, and weakness in ulnar neuropathy at the elbow.…”

mentioning

confidence: 99%

Trend of Recovery after Simple Decompression for Treatment of Ulnar Neuropathy at the Elbow

Giladi

Gaston

Haase³

et al. 2013

Plastic and Reconstructive Surgery

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Background Although numerous studies have investigated long-term outcomes after surgical treatment of ulnar neuropathy at the elbow with simple decompression, no study has evaluated the trend of postoperative recovery. The authors assessed timing of recovery after simple decompression for ulnar neuropathy at the elbow. Methods The five-center Surgery of the Ulnar Nerve Study Group prospectively recruited 58 consecutive subjects with ulnar neuropathy at the elbow and treated them with simple decompression. Patients were evaluated preoperatively and at 6 weeks, 3 months, 6 months, and 1 year postoperatively. Patient-rated outcomes questionnaires included the Michigan Hand Questionnaire; the Disabilities of the Arm, Shoulder and Hand questionnaire; and the Carpal Tunnel Questionnaire. Functional tests used were grip strength, key pinch strength, two-point discrimination, and Semmes-Weinstein monofilament testing. Postoperative improvement was assessed at each time point to establish the trend of recovery in reaching a plateau. Results Significant patient-reported symptomatic and functional recovery occurred over the first 6 weeks postoperatively as represented by improvements in questionnaire scores. Symptomatic recovery occurred earlier than functional recovery as measured by sensory and strength testing and the work domain of the Michigan Hand Questionnaire. Improvement in patient-reported outcomes continued and reached a plateau at 3 months, whereas measured strength and sensory recovery continued over 12 months. Conclusion The greatest clinical improvement after simple decompression for ulnar neuropathy at the elbow, according to questionnaire scores, occurs in the first 6 weeks postoperatively and reaches a plateau by 3 months.

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“…The reported incidence of post-operative ulnar neuropathy varies between 0 and 51% with an average of 13% [3, 7, 13–19]. Many authors advocate routine anterior transposition of the nerve [7, 13, 16, 18, 20–24], but some support the idea of placing the nerve back into its epicondylar groove after the internal fixation is completed [3, 14, 19]. …”

Section: Introductionmentioning

confidence: 99%

Subjective ulnar nerve dysfunction commonly following open reduction, internal fixation (ORIF) of distal humeral fractures and in situ decompression of the ulnar nerve

Svernlöv

Nestorson

Adolfsson

2016

Strategies in Trauma and Limb Reconstruction

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The aim of this retrospective study was to investigate the frequency of persistent ulnar affection in patients who underwent open reduction and internal fixation (ORIF) of distal humeral fractures without ulnar nerve transposition or mobilisation. Eighty-two patients (53 women), mean age 62 years, were, at a mean of 48 months, reviewed through medical records and a subjective evaluation form concerning ulnar nerve problems. Ulnar nerve affliction, in most cases regarded as mild, was experienced by 22 patients (27%; 14 women) and significantly associated with multiple surgeries. Three patients had been operated with late neurolysis and one with transposition without reported improvement. The proportion of ulnar nerve dysfunction was equally common regardless of medial or lateral plating. ORIF with plate fixation and without ulnar nerve transposition seems to be an acceptable option for patients with distal humeral fractures. The frequency of ulnar nerve affection in our series does not appear higher than previously reported. Subjective ulnar nerve symptoms were, however, relatively common and appear related to the trauma itself, the surgery, or the post-operative management which highlights the need for further analysis of these factors.

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The Ulnar Nerve in Elbow Trauma

Cited by 71 publications

References 71 publications

Treatment of supra- and intra-articular fractures of the distal humerus with the LCP Distal Humerus Plate: a 2-year follow-up

Treatment of supra- and intra-articular fractures of the distal humerus with the LCP Distal Humerus Plate: a 2-year follow-up

Trend of Recovery after Simple Decompression for Treatment of Ulnar Neuropathy at the Elbow

Subjective ulnar nerve dysfunction commonly following open reduction, internal fixation (ORIF) of distal humeral fractures and in situ decompression of the ulnar nerve

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