Need For Decompression Research Articles

Results of distraction and ligamentotaxis in thoracolumbar fractures without decompression

Background: Thoracolumbar fractures are common spinal injuries often requiring surgical intervention. Traditionally, decompression surgery has been used to relieve neural pressure. This study evaluates the effectiveness of ligamentotaxis with pedicular screw fixation, which minimizes the need for decompression, in treating thoracolumbar fractures. Methods: A retrospective cohort study was conducted at a Government Medical College, Aurangabad involving 30 patients aged 18 and older with thoracolumbar fractures treated with ligamentotaxis and pedicular screw fixation. Clinical outcomes were assessed using the visual analog scale (VAS) for pain, the American spinal injury association (ASIA) impairment scale for neurological function, and forward flexion degrees for spinal mobility. Patients were followed up for 12 months post-operatively. Results: Significant pain reduction was observed, with VAS scores decreasing from 8.5 pre-operatively to 2.5 at 12 months (p<0.001). Neurological function improved, with many patients advancing from ASIA category A pre-operatively to category D by 12 months (p<0.001). Spinal mobility showed considerable recovery, with forward flexion increasing from 0 degrees pre-operatively to 80 degrees at 12 months (p<0.001). Conclusion: Ligamentotaxis with pedicular screw fixation is an effective treatment for thoracolumbar fractures, providing substantial pain relief, neurological improvement, and restored spinal function. While outcomes are generally positive, patient selection remains critical to avoid poor neurological results. Further research is needed to refine indications and optimize treatment protocols.

National consensus survey on management approaches for upper urinary tract obstruction: A comparative analysis of retrograde ureteric stent and percutaneous nephrostomy.

To the Editor, Upper urinary tract obstruction (UUTO) is a common scenario in clinical practice, and it is caused by a variety of diseases. Lithiasis, tumours and strictures are some of the principal aetiologies. Multiple factors may influence both the need for decompression of the obstructed collecting system and the urgency of procedure...

A Survey on Compression Domain Image and Video Data Processing and Analysis Techniques

A tremendous amount of image and video data are being generated and shared in our daily lives. Image and video data are typically stored and transmitted in compressed form in order to reduce storage space and transmission time. The processing and analysis of compressed image and video data can greatly reduce input data size and eliminate the need for decompression and recompression, thereby achieving significant savings in memory and computation time. There exists a body of research on compression domain data processing and analysis. This survey focuses on the work related to image and video data. The papers cited are categorized based on their target applications, including image and video resizing and retrieval, information hiding and watermark embedding, image and video enhancement and segmentation, object and motion detection, as well as pattern classification, among several other applications. Key methods used for these applications are explained and discussed. Comparisons are drawn among similar approaches. We then point out possible directions of further research.

Prospective study of intraoperative and post-operative complications during laparoscopic cholecystectomy among patients presenting with acute calculous cholecystitis

Background: Acute cholecystitis was initially thought to be a contraindication for laparoscopic cholecystectomy. Now, as the experience is increasing, laparoscopic surgeons are gradually undertaking laparoscopic cholecystectomy as the preferred procedure even in an acute setting. Early surgery in acute presentation has better surgical outcome with lesser and cheaper hospital stay and predictive of better quality of life as compared to delayed treatment. Aims and Objectives: The objectives of this study were to study the perioperative complications during early laparoscopic cholecystectomy. Materials and Methods: One hundred and five patients with acute calculus cholecystitis visiting Fortis Escorts Hospital, Faridabad from June 2017 to November 2018 were studied. All patients underwent laparoscopic cholecystectomy and subsequently compared for the following intraoperative parameters: Presence of adhesions, calot’s anatomy, need for decompression of gallbladder, difficulty in dissecting the gallbladder from liver bed, retrieval of gallbladder, time taken to complete surgery, need of placement of drain, and need for conversion to open cholecystectomy. Complications studied were massive bleed, bile spillage during dissection, stone spillage, duodenal injury, and common bile duct [CBD] injury. Results: Decompression of the acute inflamed gallbladder facilitates laparoscopic cholecystectomy in acute cholecystitis with low conversion rate of 2.86%. Bleeding, CBD injury and duodenal injury are uncommon complications but major factors for conversion. Conclusion: Most common reasons for difficulty in laparoscopic cholecystectomy for acute cholecystitis were found to be adhesions in Calot’s triangle and adhesion of gallbladder with surrounding structures (duodenum/transverse colon).

Functional & Neurological outcome of Lumbar Microdiscectomy at L4/5 and L5/S1

Objectives: To evaluate the Functional & Neurological outcome of Lumbar Microdiscectomy at L4/5 and L5/ S1 Background: Lumbar disc herniation (LDH) is the most common specific cause for low back pain (LBP). It is a degenerative process causing annular tear with extrusion of the nucleus pulposus through posterior midline or posterolateral aspect of the disc leading to compression of the thecal sac and nerve roots with radicular symptoms. Surgery is reserved for only those who are refractory for a fair trial of nonsurgical management for at least 6 weeks, need of decompression for conus and cauda equina compression, needing immediate attention. There have been various modalities of treatment that have evolved over the years. Micro-lumbar discectomy is one of the latest additions of surgical management modality

Image Classification in JPEG Compression Domain for Malaria Infection Detection.

Digital images are usually stored in compressed format. However, image classification typically takes decompressed images as inputs rather than compressed images. Therefore, performing image classification directly in the compression domain will eliminate the need for decompression, thus increasing efficiency and decreasing costs. However, there has been very sparse work on image classification in the compression domain. In this paper, we studied the feasibility of classifying images in their JPEG compression domain. We analyzed the underlying mechanisms of JPEG as an example and conducted classification on data from different stages during the compression. The images we used were malaria-infected red blood cells and normal cells. The training data include multiple combinations of DCT coefficients, DC values in both decimal and binary forms, the “scan” segment in both binary and decimal form, and the variable length of the entire bitstream. The result shows that LSTM can successfully classify the image in its compressed form, with accuracies around 80%. If using only coded DC values, we can achieve accuracies higher than 90%. This indicates that images from different classes can still be well separated in their JPEG compressed format. Our simulations demonstrate that the proposed compression domain-processing method can reduce the input data, and eliminate the image decompression step, thereby achieving significant savings on memory and computation time.

Science, Medicine, and the Anesthesiologist

Science, Medicine, and the Anesthesiologist

Decompressive Hemicraniectomy in the Modern Era of Mechanical Thrombectomy

We aim to determine the incidence of decompressive hemicraniectomy (DHC) in the modern era of mechanical thrombectomy techniques and improved revascularization outcomes. We performed a retrospective analysis of 512 patients admitted with acute ischemic strokes with anterior circulation large-vessel occlusion that were treated by mechanical thrombectomy from 2010-2019. The primary endpoint was the need for surgical decompression. Secondary endpoints were infarct size, hemorrhagic conversion, and functional outcome at hospital discharge. Of the 512 patients, 18 (3.5%) underwent DHC at a median 2.0 days from stroke onset. The DHC group was significantly younger than the non-DHC group (P < 0.001), had worse reperfusion rates (P= 0.024) and larger infarct size (P < 0.001). Hemorrhagic conversion was more frequent in the DHC group but did not reach statistical significance (P= 0.08). From 2010-2015, 196 patients underwent a mechanical thrombectomy, 13 of whom (6.6%) required a DHC, while 316 patients underwent mechanical thrombectomy from 2016-2019 and only 5 patients required a DHC (1.6%; P= 0.002). Younger age (P < 0.001), urinary tract infection (P < 0.001) and increasing infarct size weresignificantly associated with needing a DHC. When controlling for other risk factors, higher thrombolysis in cerebral infarction score significantly reduced the need for decompressive hemicraniectomy (P= 0.004). This is one of the largest single-center experiences demonstrating that improved recanalization decreased the need for DHC without increasing the risk of hemorrhagic conversion.

Review Article On Recent Trends in Surgical Techniques for High-grade Spondylolisthesis

Introduction: High-grade spondylolisthesis is defined as cases with more than 50% displacement and spondylolisthesis with Meyerding grade III and higher. The surgical management of high-grade spondylolisthesis is highly controversial. Many surgical methods have been reported like posterior in situ fusion, instrumented posterior fusion with or without reduction, combined anterior and posterior procedures, spondylectomy with reduction of L4 to the sacrum (for spondyloptosis), posterior interbody fusion with trans-sacral fixation. Minimally invasive transforaminal lumbar interbody fusion for high-grade spondylolisthesis has also been recently mentioned in literature. This study aimed to review the recent literature which has described the surgical outcomes associated with various surgical techniques used for high-grade spondylolisthesis Materials and Methods: Recent articles were searched on search engines such as PubMed, Google Scholar with the use of Keywords like ‘High-grade Spondylolisthesis’, ‘Surgical Techniques’ ‘complications’. Discussion: The surgical management of high-grade spondylolisthesis is an area of significant controversies. The literature is replete with regards to need for reduction, need for decompression, levels of fusion, the nature of instrumentation, surgical approaches including open, minimally invasive, and “mini-open” procedures, as well as various techniques for reduction of the slip and fusion strategy. The three basic options of high-grade spondylolisthesis include in-situ fusion, partial reduction and fusion, and complete reduction. Conclusion: Various techniques have been described for high-grade spondylolisthesis. Spine Deformity Study Group (SDSG) classification gives guidelines about balanced and unbalanced pelvis and advising reduction and fusion in case of unbalanced pelvis for correction of biomechanical and global sagittal alignment. Each of the surgical techniques has their own advantages and disadvantages. Although individual a

Review Article On Recent Trends in Surgical Techniques for High-grade Spondylolisthesis

Introduction: High-grade spondylolisthesis is defined as cases with more than 50% displacement and spondylolisthesis with Meyerding grade III and higher. The surgical management of high-grade spondylolisthesis is highly controversial. Many surgical methods have been reported like posterior in situ fusion, instrumented posterior fusion with or without reduction, combined anterior and posterior procedures, spondylectomy with reduction of L4 to the sacrum (for spondyloptosis), posterior interbody fusion with trans-sacral fixation. Minimally invasive transforaminal lumbar interbody fusion for high-grade spondylolisthesis has also been recently mentioned in literature. This study aimed to review the recent literature which has described the surgical outcomes associated with various surgical techniques used for high-grade spondylolisthesis Materials and Methods: Recent articles were searched on search engines such as PubMed, Google Scholar with the use of Keywords like ‘High-grade Spondylolisthesis’, ‘Surgical Techniques’ ‘complications’. Discussion: The surgical management of high-grade spondylolisthesis is an area of significant controversies. The literature is replete with regards to need for reduction, need for decompression, levels of fusion, the nature of instrumentation, surgical approaches including open, minimally invasive, and “mini-open” procedures, as well as various techniques for reduction of the slip and fusion strategy. The three basic options of high-grade spondylolisthesis include in-situ fusion, partial reduction and fusion, and complete reduction. Conclusion: Various techniques have been described for high-grade spondylolisthesis. Spine Deformity Study Group (SDSG) classification gives guidelines about balanced and unbalanced pelvis and advising reduction and fusion in case of unbalanced pelvis for correction of biomechanical and global sagittal alignment. Each of the surgical techniques has their own advantages and disadvantages. Although individual authors’ experience, skill levels, anatomic reduction with fusion techniques has yielded highly encouraging results. Keywords: High-grade spondylolisthesis, Surgical techniques, In situ fusion, Reduction and fusion, Complications

Kinematic MRI Analysis of Reducible Atlantoaxial Dislocation for Decompression.

Background Many doctors ignored the possibility that there is still a spinal cord compression (SCC) need for decompression after atlantoaxial reduction. Reduction can be achieved on kinematic magnetic resonance imaging (MRI); thus, we want to analyze the role of kinematic MRI in reducible atlantoaxial dislocation and make a preoperative decision whether to perform decompression. Methods 36 patients with atlantoaxial reduction on preoperative kinematic MRI in extension postures were enrolled retrospectively. Grouping was based on the condition of SCC after atlantoaxial reduction preoperatively. Group A: patients with SCC after atlantoaxial reduction on dynamic cervical MRI were treated with C1 laminectomy for decompression and atlantoaxial fixation. Group B: patients with no significant SCC, according to dynamic MRI, underwent only atlantoaxial fixation. Clinical outcomes were evaluated using JOA score for spinal cord function. Radiological outcomes were assessed by measuring spinal cord diameter on MRI. Results The mean follow-up time was 17.1 months. Postoperative JOA score and percentage of SCC in both groups were significantly better than its preoperative score. There were no significant statistical differences in the JOA score at 12 months after surgery and the JOA improvement rate between two groups. All patients in the two groups had a lower percentage of SCC on preoperative extension MRI, compared with neutral MRI. No significant statistical differences in the spinal decompression improvement rate were observed between the two groups. Conclusions Decompression should be performed in patients who still have significant SCC on preoperative kinematic MRI. Kinematic MRI could be used to assess SCC and decide whether to perform decompression preoperatively.

B-Cell Lymphoma 2 (Bcl-2) Gene Is Associated with Intracranial Hypertension after Severe Traumatic Brain Injury.

Severe traumatic brain injury (TBI) activates the apoptotic cascade in neurons and glia as part of secondary cellular injury. B-cell lymphoma 2 (Bcl-2) gene encodes a pro-survival protein to suppress programmed cell death, and variation in this gene has potential to affect intracranial pressure (ICP). Participants were recruited from a single clinical center using a prospective observational study design. Inclusion criteria were: age 16-80 years; Glasgow Coma Scale (GCS) score 4-8; and at least 24 h of ICP monitoring treated between 2000-2014. Outcomes were mean ICP, spikes >20 and >25 mm Hg, edema, and surgical intervention. Odds ratios (OR), mean increases/decreases (B), and 95% confidence intervals (CIs) were reported. In 264 patients, average age was 39.2 years old and 78% of patients were male. Mean ICPs were 11.4 ± 0.4 mm Hg for patients with homozygous wild-type (AA), 12.8 ± 0.6 mm Hg for heterozygous (AG), and 14.3 ± 1.2 mm Hg for homozygous variant (GG; p = 0.023). Rs17759659 GG genotype was associated with more ICP spikes >20 mm Hg (p = 0.017) and >25 mm Hg (p = 0.048). Multi-variate analysis showed that GG relative to AA genotype had higher ICP (B = 2.7 mm Hg, 95% CI [0.5,4.9], p = 0.015), edema (OR = 2.5 [1.0, 6.0], p = 0.049) and need for decompression (OR = 3.7 [1.5-9.3], p = 0.004). In this prospective severe TBI cohort, Bcl-2 rs17759659 was associated with increased risk of intracranial hypertension, cerebral edema, and need for surgical intervention. The variant allele may impact programmed cell death of injured neurons, resulting in elevated ICP and post-traumatic secondary insults. Further risk stratification and targeted genotype-based therapies could improve outcomes after severe TBI.

Restricted Entropy and Spectrum Properties for the Compressively Sensed Domain in Hyperspectral Imaging

The restricted isometry property (RIP) and restricted conformal property (RCP) are two fundamental properties widely used in compressive sensing (CS) for sampling sparse signals. These two properties are sufficient to preserve the magnitude of a signal vector and the angle between two signal vectors in the compressively sensed band domain (CSBD), respectively. This article derives two new CS properties for hyperspectral signal vectors (HSVs), to be called the restricted entropy property (REP) and restricted spectrum property (RSP), which can be shown to preserve the entropy of an HSV and the spectral similarity between two HSVs in CSBD in correspondence to RIP and RCP, respectively. These two properties enable hyperspectral analysis algorithms to be directly applied to CSBD without loss of data integrity, while the dimensionality of CSBD can be considerably reduced. Most importantly, REP and RSP preserve exploitation algorithm performance without the need for decompression so as to avoid specifying a sparse basis.

A heuristics based global navigation satellite system data reduction algorithm integrated with map-matching

The transmission and storage of global navigation satellite system (GNSS) data places very high demands on mobile networks and centralised data processing systems. GNSS applications including community based navigation and fleet management require GNSS data to be transmitted from a vehicle to a centralised system and then processed by a map-matching algorithm to determine the location of a vehicle within a road segment. Various data compression techniques have been developed to reduce the volume of data transmitted. There is also an independent literature relating to map-matching algorithms. However, no previous research has integrated data compression with a map-matching algorithm that accepts compressed data as an input without the need for decompression. This paper develops a novel GNSS data reduction algorithm with deterministic error bounds, which was seamless integrated with a specifically designed map-matching algorithm. The approach significantly reduces the volume of GNSS data communicated and improves the performance of the map-matching algorithm. The data compression extracts critical points in the trajectory and velocity–time curve of a vehicle. During the process of selecting critical points, the error of restoring vehicle trajectories and velocity–time curves are used as parameters to control the number of critical points selected. By setting different error bound values prior to the execution of the algorithm, the accuracy and volume of reduced data is controlled precisely. The compressed GNSS data, particularly the critical points selected from the vehicle’s trajectory is directly input to the map-matching algorithm without the need for decompression. An experiment indicated that the data reduction algorithm is very effective in reducing data volume. This research will be useful in many fields including community driven navigation and fleet management.

Пояснично-тазовая транспедикулярная фиксация вертикально-нестабильных повреждений тазового кольца

Introduction Identification of a proper fixation of the posterior pelvic ring is of paramount importance in treatment of patients with vertically unstable pelvic injuries. Material and methods Outcomes of 29 patients with polytrauma and vertically unstable pelvic injuries treated at Level I Trauma Center between 2013 and 2017 were analyzed. The mean age of the patients was 34.8 ± 99 years. The severity of the injuries and patients’ condition were evaluated using Injury Severity Score (ISS), VPKh-P (MT), VPKh-SP, and Yu. N. Tsibin scales (1975) to determine the sequence of treatment and diagnostic procedures. Classification offered by Pape H. C. (2005) was used to evaluate physiological condition. The ISS score was 27.1 ± 9.9. All patients underwent computed tomography (CT) scan of pelvic for preoperative planning. Lumbopelvic transpedicular fixation (LPTF) was employed as a definitive treatment of vertically unstable pelvic ring fractures in all clinical observations. Posterior half-ring morphology, a need for decompression of the nerve roots of the sacral plexus, timing of surgery were considered to decide on LPTF configuration. Results Three-month-to-six-year follow-ups of 22 patients showed good and excellent results achieved in 72.7 % of the cases that are in line with findings reported in the literature. Discussion Biomechanically adequate method of internal fixation is the method of choice in the definitive treatment of vertical unstable pelvic injuries with the possibility of decompression of compromised neural structures. Lumbopelvic fixation with the possibility of simultaneous access for decompression of neural structures is the most optimal technique for these complicated injuries.

Ventricular Drainage Catheters versus Intracranial Parenchymal Catheters for Intracranial Pressure Monitoring-Based Management of Traumatic Brain Injury: A Systematic Review and Meta-Analysis.

Intracranial pressure (ICP) monitoring is one of the mainstays in the treatment of severe traumatic brain injury (TBI), but different approaches to monitoring exist. The aim of this systematic review and meta-analysis is to compare the effectiveness and complication rate of ventricular drainage (VD) versus intracranial parenchymal (IP) catheters to monitor and treat raised ICP in patients with TBI. Pubmed, Embase, Web of Science, Google Scholar, and the Cochrane Database were searched for articles comparing ICP monitoring-based management with VDs and monitoring with IP monitors through March 2018. Study selection, data extraction, and quality assessment were performed independently by two authors. Outcomes assessed were mortality, functional outcome, need for decompressive craniectomy, length of stay, overall complications, such as infections, and hemorrhage. Pooled effect estimates were calculated with random effects models and expressed as relative risk (RR) for dichotomous outcomes and mean difference (MD) for ordinal outcomes, with corresponding 95% confidence intervals (CI). Six studies were included: one randomized controlled trial and five observational cohort studies. Three studies reported mortality, functional outcome, and the need for a surgical decompression, and three only reported complications. The quality of the studies was rated as poor, with critical or serious risk of bias. The pooled analysis did not show a statistically significant difference in mortality (RR = 0.90, 95% CI = 0.60-1.36, p = 0.41) or functional outcome (MD = 0.23, 95% CI = 0.67-1.13, p = 0.61). The complication rate of VDs was higher (RR = 2.56, 95% CI = 1.17-5.61, p = 0.02), and consisted mainly of infectious complications; that is, meningitis. VDs caused more complications, particularly more infections, but there was no difference in mortality or functional outcome between the two monitoring modalities. However, the studies had a high risk of bias. A need exists for high quality comparisons of VDs versus IP monitor-based management strategies on patient outcomes.

Evaluating the Extent of Clinical Variability Among Treatment Options for Patients With Adult Spinal Deformity.

This is a surgical strategy survey. The purpose of this study was to evaluate the variability in in surgical strategy planning of adult spinal deformity (ASD) based on patients' clinical and radiographic data. Literature guiding the management of ASD consists primarily of studies with low levels of evidence. Recent studies have demonstrated good agreement among surgeons about the factors influencing surgical decision but poor agreement about the need for surgery. Therefore there is a relative lack of consensus and guidelines in the clinical practice and treatment of ASD. A total of 28 adult deformity surgeons were asked to fulfill an online survey of 10 spinal deformity cases. Case presentation included a clinical vignette with photographs, Oswestry Disability Index and Visual Analog Scale scores and imaging with radiographic measurements. For each case, the surgeons were asked whether surgical management would be beneficial and if so, their surgical plan (approach, staging, need for fusion, osteotomy or decompression and the techniques used). Intraobserver and interobserver reliability were studied using average Cohen and Feiss Kappa statistics, respectively. Descriptive statistics were calculated to evaluate the frequency of each of the alternatives in surgical planning. Average intrarater and interrater agreement for surgical strategy were evaluated to be substantial (κ=0.62) and fair (κ=0.24), respectively. Detailed interrater statistics demonstrates that there was only slight agreement on the need for surgery (κ=0.15), the approach (κ=0.15), and the need for fusion (κ=0.16) while moderate agreement was reached for the need for decompression (κ=0.42) and osteotomy (κ=0.29). Among surgeons, agreement about the need for surgery and the surgical strategy for ASD is limited. Findings from this survey highlight the need for comprehensive classifications for ASD, higher-level studies including randomized trials to set guidelines and lessen the variability in clinical practices, which would then hopefully lead to improved outcomes.

Incidence and Implications of Left Ventricular Distention During Venoarterial Extracorporeal Membrane Oxygenation Support.

Left ventricular distention (LVD) during venoarterial extracorporeal membrane oxygenation (VA-ECMO) support is increasingly recognized but seldom reported in the literature. The current study defined LVD as not present (LVD-); subclinical (LVD+, evidence of pulmonary edema on chest radiograph AND pulmonary artery diastolic blood pressure greater than 25 mm Hg within the first 2 hours of intensive care unit admission); or clinical (LVD++, need for decompression of the left ventricle immediately following VA-ECMO initiation). Among 226 VA-ECMO device runs, 121 had sufficient data to define LVD retrospectively. Nine patients (7%) developed LVD++ requiring immediate decompression, and 27 patients (22%) met the definition of LVD+. Survival to discharge was similar among groups (LVD++: 44%, LVD+: 41%, LVD-: 44%). However, myocardial recovery appeared inversely related to the degree of LVD (LVD++: 11%, LVD+: 26%, LVD-: 40%). When death or transition to device was considered as a composite outcome, event-free survival was diminished in LVD++ and LVD+ patients compared with LVD-. Multivariable analysis identified cannulation of VA-ECMO during extracorporeal cardiopulmonary resuscitation (ECPR) as a risk factor for decompression (odds ratio [OR]: 3.64, confidence interval [CI]: 1.21-10.98; p = 0.022). Using a novel definition of LVD, the severity LVD was inversely related to the likelihood of myocardial recovery. Survival did not differ between groups. Extracorporeal cardiopulmonary resuscitation was associated with need for mechanical intervention.

Low Bit-rate 3D feature descriptors for depth data from Kinect-style sensors

In applications that require an input point cloud to be matched with a set of database point clouds present on a remote server, it is preferable to compress and transfer 3D feature descriptors online, rather than compressing and transferring the whole input point cloud. This is because the former would require much lesser bandwidth and does not require feature extraction on the server. Existing real valued 3D feature descriptors that offer good keypoint matching performance require higher bandwidth for their transfer over the network. On the other hand, the existing binary 3D feature descriptor requires relatively less bandwidth but offers reduced keypoint matching performance. In this paper, we propose to employ lattice quantization to efficiently compress 3D feature descriptors. These compressed 3D feature descriptors can be directly matched in compressed domain without any need for decompression, hence drastically reducing the memory footprint and computational requirements. We also propose double stage lattice quantization to achieve even more compression in the case of SHOT 3D feature descriptor. We provide a spectrum of possible bit rates and achievable keypoint matching performance for three state-of-the-art 3D feature descriptors. Experimental evaluation on publicly available benchmark dataset highlights that the compressed 3D feature descriptors require much lesser bandwidth and yet offer good keypoint matching performance. The source code is made publicly available for the benefit of the community.

Ulnar neuropathy: evaluation and management.

Ulnar neuropathy is commonly encountered, both acutely after elbow trauma and in the setting of chronic compression neuropathy. Careful clinical evaluation and discerning evaluation of electrodiagnostic studies are helpful in determining the prognosis of recovery with nonoperative and operative management. Appreciation of the subtleties in clinical presentation and thoughtful consideration of the timing and type of surgical intervention are critical to optimizing outcomes after treatment of ulnar neuropathy. The potential need for decompression at both the cubital tunnel and Guyon's canal must be appreciated. Supplementation of decompression with supercharged end-to-side nerve transfer can expedite motor recovery of the ulnar intrinsic muscles in the appropriately selected patient. The emergence of nerve transfer techniques has also changed the management of acute ulnar nerve injuries.