Author/Editor		Krkovič, M; Kordaš, M; Tonin, M; Bošnjak, R
Title		Subperiosteal elevation of the ulnar nerve during internal fixation for fractures of the distal humerus assessed by intra-operative neurophysiological monitoring
Type		članek
Source		J Bone Joint Surg Br
Vol. and No.		Letnik 88, št. 2
Publication year		2006
Volume		str. 220-6
Language		eng
Abstract		Ulnar nerve function, during and after open reduction and internal fixation of fractures of the distal humerus with subperiosteal elevation of the nerve, was assessed by intra-operative neurophysiological monitoring. Intermittent recording of the compound muscle action potentials was taken from the hypothenar muscles in 18 neurologically asymptomatic patients.The mean amplitude of the compound muscle action potential after surgery was 98.1% (sd 17.6; -37% to +25%). The amplitude improved in six patients following surgery. Despite unremarkable recordings one patient had progressive paresis. Motor impairment is unlikely if the compound muscle action potential is continuously preserved and not reduced by more than 40% at the end of surgery. Temporary decreases in amplitude by up to 70% were tolerated without clinical consequences. However, repeated clinical examination is obligatory to recognise and treat early post-operative palsy.
Descriptors		ACTION POTENTIALS ADULT AGED AGED, 80 AND OVER FRACTURE FIXATION, INTERNAL HUMERAL FRACTURES INTRAOPERATIVE CARE MONITORING, PHYSIOLOGIC MUSCLE, SKELETAL NEURAL CONDUCTION OSTEOTOMY POSTOPERATIVE PERIOD ULNAR NERVE