Ulnar neuropathy after median sternotomy

C. D. Casscells, R. W. Lindsey, J. Ebersole, B. Li

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34 Scopus citations

Abstract

Ulnar neuropathy is a known complication of median sternotomy surgery, and its precise cause is not clear. The authors hypothesize that a 'double- crush' phenomenon caused by intraoperative compression of the brachial plexus occurs in a patient with preexisting, previously undiagnosed slowing of ulnar nerve conduction. Eighty-four arms in 42 patients scheduled for cardiac surgery were studied. Pre- and postoperative history and physical examinations were performed by separate blinded examiners; however, the nerve conduction studies were performed by a single examiner. Fifteen arms (18%) in 11 patients (26%) clinically demonstrated postoperative neuropathy. After surgery, all symptomatic patients had considerable slowing of their preoperative conduction studies. A direct correlation appears to exist between preoperative slowing of ulnar nerve conduction and postmedian sternotomy neuropathy. A careful preoperative evaluation including nerve conduction studies may detect the predisposed patient; the surgeon attempting postoperative cubital tunnel decompression is cautioned that the lesion may not be an isolated one.

Original languageEnglish (US)
Pages (from-to)259-265
Number of pages7
JournalClinical orthopaedics and related research
Issue number291
StatePublished - Jan 1 1993
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Casscells, C. D., Lindsey, R. W., Ebersole, J., & Li, B. (1993). Ulnar neuropathy after median sternotomy. Clinical orthopaedics and related research, (291), 259-265.