Purpose
To identify the incidence and the factors associated with a postoperative ulnar nerve
neuropathy in patients who had undergone open reduction and internal fixation for
intraarticular distal humerus fractures.
Methods
We retrospectively reviewed 116 patients who had undergone surgery between January
2011 and December 2020. Age, sex, BMI, mechanism of injury, open or closed fracture,
operation time, tourniquet time, and nerve injury at the final examination were collected
from medical charts. We essentially used the paratricipital approach. In cases in
which the reduction of intraarticular bone fragments was difficult, olecranon osteotomy
was used. Ulnar nerve function was graded according to a modified system of McGowan.
We conducted logistic regression analysis to investigate factors of neuropathy using
items identified as statistically significant in univariate analysis as explanatory
variables.
Results
Thirty-four patients (29.3%) had persistent neuropathy at the final follow-up. In
the modified McGowan classification, 28 patients had grade 1 and 6 patients had grade
2 neuropathy. Olecranon osteotomy emerged as a distinct explanatory variable for the
prophylaxis of ulnar nerve neuropathy in the multivariate analysis (odds ratio, 0.30;
95% confidence interval, 0.12–0.73). Anterior transposition, however, was not a statistically
significant factor (odds ratio, 1.91; 95% confidence interval, 0.81–4.56).
Conclusions
Olecranon osteotomy was the only independent factor associated with preventing the
occurrence of ulnar nerve neuropathy. Ulnar nerve transposition might not be associated
with prevention of ulnar nerve neuropathy.
Type of study/level of evidence
Prognostic IV.
Key words
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Article info
Publication history
Published online: March 15, 2023
Accepted:
February 1,
2023
Received:
March 22,
2022
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly to this article.
Identification
Copyright
© 2023 by the American Society for Surgery of the Hand. All rights reserved.
