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Published on: August 15, 2019
Surgical outcomes of ulnar nerve lesions in children. A retrospective clinical study
Alper Baysefer1, Yusuf Izci, Kamil Melih Akay
1Department of Neurosurgery, School of Medicine, Gulhane Military Medical Academy, Ankara, Turkey.
Insights
Pediatric ulnar nerve lesions show better outcomes with simple decompression surgery. Neurolysis also yielded good results, but fair outcomes were seen in discontinuous lesions, highlighting surgical approach importance.
Area of Science:
- Neurology
- Pediatric Surgery
- Nerve Injury
Background:
- The ulnar nerve is crucial for hand and digit motor function.
- Ulnar nerve injuries commonly occur due to trauma or entrapment at the wrist, forearm, or elbow.
- Pediatric ulnar nerve lesions exhibit faster axonal regeneration and greater neural plasticity compared to adults.
Purpose of the Study:
- To evaluate neurological outcomes in pediatric ulnar nerve lesions based on surgical treatment type.
- To compare the effectiveness of different surgical interventions for pediatric ulnar nerve injuries.
Main Methods:
- Analysis of 21 pediatric patients with ulnar nerve lesions undergoing surgery between 1995 and 2002.
- Categorization of surgical treatments including simple decompression and neurolysis.
- Assessment of neurological outcomes based on lesion type and surgical procedure.
Main Results:
- Simple decompression surgery resulted in excellent outcomes (100%) for pediatric ulnar nerve lesions.
- Neurolysis achieved excellent results in nearly 58% and good results in 33% of cases.
- Fair results were observed in surgeries for discontinuous ulnar nerve lesions.
Conclusions:
- Simple decompression is highly effective for pediatric ulnar nerve lesions.
- Surgical approach significantly influences neurological outcomes in pediatric ulnar nerve injuries.
- Further research may be needed for optimizing treatment of discontinuous lesions.
Abstract:
The ulnar nerve provides the major motor innervation of the interosseous muscles of the hand and the flexor muscles of the wrist and the fourth and fifth digits. Injury is most common at the wrist, forearm or elbow, secondary to trauma or entrapment. Pediatric ulnar nerve lesions differ from adult lesions by their quicker axonal regeneration. Neural plasticity is also greater in children. We analyzed 21 pediatric patients with ulnar nerve lesion who underwent surgical treatment between 1995 and 2002 to determine if there were differences in the neurological outcome in terms of the type of lesion and surgery. Data showed that excellent results were found in 100% of the lesions treated by simple decompression and nearly 58% of the lesions treated by neurolysis. Good results were obtained in 33% of lesions treated by neurolysis. There were fair results for surgery performed in discontinuous lesions.
