Ulnar Groove Research Articles

Operative treatment of ulnar nerve neuropathy in the elbow region. A clinical and electrophysiological study.

Thirty-three patients with ulnar nerve neuropathy due to a lesion in the ulnar groove were operated upon during a 5-year period. All the patients were analyzed preoperatively. One-third of the patients had a history of alcohol abuse. Twenty-five of the patients were subjected to anterior transposition of the ulnar nerve. The results after transposition have been compiled according to etiology, duration, age and alcohol abuse. All seven patients with only subjective symptoms improved; 11 out of 18 (61 per cent) with motor and/or sensory loss also improved but only six (33 per cent) recovered completely. Overall, 21 patients (84 per cent) were improved by the operation. In 11 of the transposition cases the ulnar nerve was examined electrophysiologically before and after operation and an improvement of the motor conduction velocity within the elbow segment of the nerve was found in 10 cases.

Postsurgical Ulnar Neuropathy

To the Editor.— Drs. Murphy and Devers (227:1123, 1974) are correct in emphasizing that one must be alert to avoid the problem of ulnar neuropathy during the time a patient is anesthetized and defenseless. However, in my experience, it is much more common to see this complication occur several days or more postoperatively. The seriously ill patient or the orthopedic patient in traction cannot move much in bed, and often lies with the hands on the abdomen and the elbows flexed. This puts direct pressure on the ulnar groove and the ulnar nerve. Many hospital mattresses are covered with a firm layer of plastic; this adds to the pressure on the ulnar nerve. The condition is diagnosed easily by the location of the symptoms (fourth and fifth fingers) and by tenderness over the ulnar nerve behind the medial epicondyle. It is helpful to place a pillow at the patient's side

Prevention of Postsurgical Ulnar Neuropathy

<h3>To the Editor.—</h3> Ulnar paresthesia involving one or both hands or forearms, can be a rare but distressing and troublesome complication of major surgical procedures performed under general anesthesia on parts of the body other than the arms. Operations undertaken when the patient is in the face-down position (eg, lumbar laminectomy) are a particular source of this complication, but we have seen ulnar paresthesia of lengthy persistence following appendectomy, removal of a knee cartilage, repair of dislocation of the shoulder, and cholecystectomy. The causative factor appears to be compression of the ulnar groove of the elbow on the edge of an armboard or on an outrigging bar that runs along the edge of the operating table and is used for attachment of lateral supports such as those employed in operations upon the kidney. The arm is often held in place alongside the body by the lifting sheet used to transport