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Current Concepts Review   |    
The Ulnar Nerve in Elbow Trauma
Robert Shin, MD1; David Ring, MD1
1 Massachusetts General Hospital, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114. E-mail address for D. Ring: dring@partners.org
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Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from the AO Foundation, Small Bone Innovations, Smith and Nephew, Wright Medical Technology, and Biomet. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2007 May 01;89(5):1108-1116. doi: 10.2106/JBJS.F.00594
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Extract

The prevalence of ulnar nerve dysfunction after elbow injury is unknown because authors of published investigations have inadequately differentiated among acute injury-related, acute surgery-related, and delayed (subacute or chronic) ulnar neuropathies and these retrospective case series have not included careful evaluation of ulnar nerve function. Ulnar neuropathy is well documented after distal humeral fracture, but it can also develop following any complex elbow trauma. The ulnar nerve should be identified and protected during the treatment of a bicolumnar fracture of the distal part of the humerus, but current data are inconclusive regarding the value of routine anterior transposition of the nerve. Although most delayed ulnar neuropathies present at a relatively late stage with weakness, with or without muscle atrophy, improved motor strength may be observed in some patients many years after ulnar nerve decompression. Ulnar nerve decompression and transposition are becoming an integral part of many posttraumatic reconstructive elbow procedures, but most recommendations for management of the ulnar nerve are based on retrospective reviews, anecdotal reports, and expert opinion.
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