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Related Concept Videos

Spinal Nerves: Plexus I01:22

Spinal Nerves: Plexus I

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Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
The Cervical Plexus
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Bones of the Upper Limb: Radius01:09

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The radius is longer of the two bones that make up the human antebrachium or forearm. At the proximal end, the radius articulates with the capitulum of the humerus and the radial notch of the ulna to form the elbow joint. At the distal end, the radius articulates with the ulna via the ulnar notch, forming the distal radioulnar joint. Distally, the radius also attaches to the carpal wrist bones (scaphoid and lunate) to form the radiocarpal joint.
The radius has a nail-shaped head, and a...
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Ulnar Nerve Management in Complex Elbow Dislocations: A Retrospective Monocentric Study.

Carlotta Faccenda1,2, Elisa Dutto1, Francesco Bosco3,4

  • 1Hand Surgery and Reconstructive Microsurgery Department, CTO Hospital, A.O.U. Città della Salute e della Scienza, 10126 Turin, Italy.

Journal of Personalized Medicine
|November 26, 2024
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Summary

Routine ulnar nerve transposition in complex elbow dislocations may increase neuropathy incidence. While symptoms were less severe, they lasted longer, suggesting surgeons should avoid this procedure unless necessary.

Keywords:
complex elbow dislocationsulnar nerveulnar nerve transposition

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Area of Science:

  • Orthopedic surgery
  • Neurology
  • Traumatology

Background:

  • Complex elbow dislocations pose a risk to the ulnar nerve due to its anatomy.
  • Limited literature exists on managing ulnar nerve issues and neuropathy in these injuries.
  • Understanding the relationship between ulnar nerve transposition and outcomes is crucial.

Purpose of the Study:

  • To investigate the incidence of ulnar nerve pain after complex elbow dislocations.
  • To determine the relationship between ulnar nerve transposition and the occurrence and duration of neuropathy.
  • To evaluate functional outcomes using standardized scoring systems.

Main Methods:

  • Retrospective review of 44 patients with complex elbow dislocations.
  • Categorization of injuries (e.g., trans-olecranon fracture-dislocation, Terrible Triad).
  • Assessment of ulnar nerve release/transposition, postoperative ulnar pain, and functional scores (MEPS, DASH, OES).

Main Results:

  • Higher incidence of neuropathy in patients who underwent simultaneous ulnar nerve transposition.
  • Neuropathy symptoms were less severe but of longer duration with transposition.
  • No statistically significant differences in MEPS, DASH, or OES between groups, though slightly better without transposition.

Conclusions:

  • Routine ulnar nerve transposition is not recommended for complex elbow dislocations.
  • Further research with larger cohorts is needed to confirm these findings.
  • Individualized treatment decisions are essential for managing ulnar nerve involvement in elbow injuries.