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Late ulnar paralysis. Study of seventeen cases
M Mansat1, P Bonnevialle, X Fine
1Service de Chirurgie Orthopédique et Réparatrice, Hôtel-Dieu, Toulouse, France.
Annales De Chirurgie De La Main : Organe Officiel Des Societes De Chirurgie De La Main
|January 1, 1983
Summary
Late ulnar paralysis, often linked to cubitus valgus, shows limited recovery after neurolysis-transposition. Surgical release of the flexor carpi ulnaris arcade is crucial for managing nerve compression.
Area of Science:
- Orthopedic Surgery
- Neurology
Background:
- Late ulnar paralysis presents with prolonged latency, rapid onset, and severe symptoms.
- Cubitus valgus and nerve compression proximal to the flexor carpi ulnaris arcade are common.
- Subcutaneous ulnar transposition is a frequent surgical approach.
Purpose of the Study:
- To report on 17 cases of late ulnar paralysis treated with neurolysis-transposition.
- To emphasize clinical characteristics and anatomical findings.
- To evaluate the effectiveness of surgical intervention.
Main Methods:
- Retrospective analysis of 17 patients with late ulnar paralysis.
- Surgical treatment involving neurolysis and ulnar transposition (often subcutaneous).
- Anatomical study of the ulnar nerve path, focusing on the flexor carpi ulnaris arcade.
Main Results:
- No patient achieved complete cure; only 50% showed improvement.
- Cubitus valgus and compression at the flexor carpi ulnaris arcade were consistently observed.
- Anatomical study highlighted the flexor carpi ulnaris arcade's role in nerve compression.
Conclusions:
- Neurolysis-transposition yields limited recovery for established late ulnar paralysis.
- Longitudinal opening of the flexor carpi ulnaris arcade is the key neurolysis procedure.
- Prophylactic surgical intervention is recommended before neuropathy onset in misaligned elbows from childhood injuries.