Preoperative sonographic ulnar nerve mapping in the postoperative elbow

Area of Science:

• Orthopedic Surgery
• Diagnostic Imaging
• Neurology

Background:

• Postoperative elbow surgery can lead to complex anatomical challenges.
• Accurate localization of the ulnar nerve is crucial for revision or subsequent elbow procedures.
• Uncertainty in nerve palpation can increase the risk of iatrogenic injury.

Purpose of the Study:

• To describe the technique of sonographic ulnar nerve mapping in the postoperative elbow.
• To evaluate its utility in surgical planning for subsequent elbow interventions.
• To assess its role in mitigating ulnar nerve injury risk.

Main Methods:

• Retrospective review of 24 patients (≥18 years) undergoing preoperative sonographic ulnar nerve mapping.
• Analysis of patient demographics, clinical presentation, prior surgeries, and ultrasound technique.
• Review of intraoperative and postoperative outcomes, including nerve injury.

Main Results:

• The cohort (mean age 51, mean BMI 29) had prior elbow surgeries, including ulnar nerve transposition.
• Sonographic mapping guided surgical approach modifications in 11 of 24 cases.
• No perioperative ulnar nerve-related complications, such as nerve transection, were reported.

Conclusions:

• Preoperative sonographic ulnar nerve mapping facilitates surgical access planning and nerve dissection.
• This technique reduces uncertainty in nerve palpation in complex postoperative elbows.
• Sonographic mapping may mitigate the risk of iatrogenic ulnar nerve injury.