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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2008 February;59(1):21-5
Microsurgical treatment of ulnar nerve lesion: evaluation of 100 patients
Masini M., Oliveira De Amorim R. L., Silva Paiva W.
University of Planalto Central Peripheral Nerve Surgery Unit, Brasilia, Brazil
Aim. Ulnar nerve is the main nerve of the medial trunk of brachius plexus. Its injury develops in cases of trauma, elbow fractures, entrapments, lacerations, gunshots wounds and tumours. The aim of this study was to describe 100 cases of ulnar lesions subjected to surgical treatment.
Methods. One hundred patients with traumatic ulnar nerve lesion, with more 3-month post-trauma were retrospective assessed. The patients were evaluated according to the surgical procedures. The medium follow up was 18 months. A patient clinical profile was delineated starting from a protocol that was obtained, including data as sex, age, occupation, site and type of the nerve lesion, as its associated injuries.
Results. Most commom injuries were lesions lacerations (65%), fractures/dislocations (19%), entrapments (10%) and gunshot wounds (6%). Aided by intraoperative nerve action potential recording, lesions in continuity received neurolysis and split repair or resection followed by end-to-end suture or graft repair. Thirty-nine patients received neurolysis, 40 were submitted to graft repair and 21 to end-to-end suture. Good to excellent functional recovery were achieved in 64% patients who underwent neurolysis, 45% patients who received suture repair and 33% patients who received graft repair. Of those submitted to graft repair anastomosis (GRA), only 33% presented good to excellent recovery and 41% were classified as bad functional result (P<0.001).
Conclusion. Careful preoperative combined evaluation can establish proper surgical management of ulnar nerve injuries to good funtional recoveries.