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 language | English (US) |
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Pages (from-to) | 259-265 |
Number of pages | 7 |
Journal | Clinical orthopaedics and related research |
Volume | 291 |
DOIs | |
State | Published - 1993 |
Externally published | Yes |
ASJC Scopus subject areas
- Surgery
- Orthopedics and Sports Medicine