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Ulnar-Sided Upper Extremity Traumatic Wounds: What Should We Expect to Find?
João Q Costa1, Maria J Leite1, Miguel Relvas1
1São João University Hospital, Porto, Portugal.
The Journal of Hand Surgery Asian-Pacific Volume
|September 27, 2023
Summary
Injuries to the ulnar side of the upper extremity, particularly ulnar nerve lesions (UNL), often result in significant functional deficits and sequelae. Surgical exploration is recommended due to frequent neurovascular and tendinous damage.
Area of Science:
- Orthopedics
- Traumatology
- Neurosurgery
Background:
- Upper limb traumatic injuries significantly impact daily life.
- Studies on ulnar-sided forearm, wrist, and hand injuries are limited.
- This study addresses the paucity of research on these specific injuries.
Purpose of the Study:
- To characterize injuries affecting the ulnar side of the forearm, wrist, and hand.
- To evaluate clinical, neurological, and functional outcomes of surgical treatment.
- To identify factors influencing patient outcomes.
Main Methods:
- Retrospective single-blinded study (2006-2016).
- Included patients with deep traumatic wounds on the ulnar side requiring surgery.
- Assessed sample characteristics, concomitant injuries, and clinical outcomes, including neurological and functional evaluations.
Main Results:
- 61 patients analyzed; 69% wrist injuries, 90% neurological lesions (primarily ulnar nerve lesion - UNL).
- Common concomitant injuries: flexor carpi ulnaris (64%), fractures (13%), ulnar artery lesions (39%).
- 34% had no deficits at 8.6-year follow-up; UNL patients showed worse functional scores and higher sequelae risk. Sensory deficits also correlated with poorer outcomes.
Conclusions:
- Ulnar nerve lesions (UNL) significantly impair hand function, especially the first ray.
- Both motor and sensory deficits negatively impact functional outcomes.
- Surgical exploration is recommended for ulnar-sided upper extremity wounds due to high rates of neurovascular and tendinous lesions.
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