Extract
The prevalence of
ulnar nerve dysfunction after elbow injury is unknown because authors of
published investigations have inadequately differentiated among acute
injury-related, acute surgery-related, and delayed (subacute or chronic) ulnar
neuropathies and these retrospective case series have not included careful
evaluation of ulnar nerve function. Ulnar neuropathy is
well documented after distal humeral fracture, but it can also develop
following any complex elbow trauma. The ulnar nerve should
be identified and protected during the treatment of a bicolumnar fracture of
the distal part of the humerus, but current data are inconclusive regarding
the value of routine anterior transposition of the nerve. Although most delayed
ulnar neuropathies present at a relatively late stage with weakness, with or
without muscle atrophy, improved motor strength may be observed in some
patients many years after ulnar nerve decompression. Ulnar nerve
decompression and transposition are becoming an integral part of many
posttraumatic reconstructive elbow procedures, but most recommendations for
management of the ulnar nerve are based on retrospective reviews, anecdotal
reports, and expert opinion.