Author/Editor		Krkovič, Matija
Title		Elektrofiziološko spremljanje delovanje ulnarnega živca med operacijsko oskrbo znotrajsklepnih zlomov končnega dela nadlahtnice pri odraslih
Type		monografija
Place		Ljubljana
Publisher		Univerza v Ljubljani, Medicinska fakulteta
Publication year		2006
Volume		str. 117
Language		slo
Abstract		Introduction: Subperiostal elevation of the ulnar nerve is a novel and minimally-invasive surgical technique which enables indirect manipulation of the ulnar nerve during dorsal plating for distal humerus fractures, without simple decompression of the nerve in the cubital tunnel. This technique was pioneered by dr. Korošec in order to decrease the rate of delayed ulnar neuropathy from excessive perineural scarring which follows opening of the cubital tunnel as seen in simple decompression of the ulnar nerve or transposition procedures. In this technique, the ulnar nerve remains within its fibrous envelope during temporary mobilisation from its bony bed of the retroepicondylar groove. Non visualisation of the ulnar nerve was substituted for by neurophysiological monitoring of the ulnar nerve function during surgery by intermittent recordings of compound muscle action potentials (CMAP) from the hypothenar muscles. The aim of the study was to estimate the risk of perioperative ulnar neuropathy during subperiostal elevation of the ulnar nerve and other surgical steps. Patients and methods: Eighteen patients, 11 women and 7 men (56,9 years +- 17,9 old), who suffered closed fracture of the distal humerus and had no sign or symptoms of ulnar neuropathy, were included in the study. The voluntary force of abduction/adduction of the fifth finger, as assessed preoperatively by spring dynamometer, was statistically not different when comparing the injured and noninjured side (paired t-test). The mean motor conduction velocity was 58,8 m/s +- 6,9 ( 48,4 - 71,8m/s). The CMAP was measured upon percutaneous stimulation of the ulnar nerve in the axilla. The patients underwent surgery 6,6 = 8 days after injury and were operated on by the same surgeon (M.K.). (Abstract truncated at 2000 characters)
Descriptors		HUMERAL FRACTURES ULNAR NERVE FRACTURE FIXATION NEURAL CONDUCTION FRACTURES, CLOSED BONE SCREWS TREATMENT OUTCOME ADULT BONE PLATES