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[PMID]:29169602
[Au] Autor:Shearin JW; Chapman TR; Miller A; Ilyas AM
[Ad] Endereço:Hand & Upper Extremity Surgery, Department of Orthopedic Surgery, Arnot Health, Elmira, NY, USA.
[Ti] Título:Ulnar Nerve Management with Distal Humerus Fracture Fixation: A Meta-Analysis.
[So] Source:Hand Clin;34(1):97-103, 2018 02.
[Is] ISSN:1558-1969
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Ulnar nerve dysfunction following distal humerus fractures is a well-recognized phenomenon. There is no consensus regarding optimal handling of the ulnar nerve during surgical management of these fractures between in situ management and transposition. Using an electronic database to identify retrospective studies involving surgical fixation of distal humerus fractures yielded 46 studies, 5 trials meeting the authors' inclusion criteria, totaling 362 patients. An overall incidence of 19.3% for ulnar neuropathy was identified. Of those patients undergoing in situ release, the incidence was 15.3%. Of those who underwent transposition, there was a 23.5% incidence of ulnar neuropathy.
[Mh] Termos MeSH primário: Fixação de Fratura/efeitos adversos
Fraturas do Úmero/cirurgia
Neuropatias Ulnares/etiologia
Neuropatias Ulnares/prevenção & controle
[Mh] Termos MeSH secundário: Seres Humanos
Fraturas do Úmero/complicações
Cuidados Intraoperatórios
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180303
[Lr] Data última revisão:
180303
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171125
[St] Status:MEDLINE


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[PMID]:29201310
[Au] Autor:El-Sobky TA; Haleem JF; Sakr HM; Aly AS
[Ad] Endereço:Division of Pediatric Orthopedics, Department of Orthopedic Surgery, Ain-Shams University Faculty of Medicine, Cairo, Egypt.
[Ti] Título:A Neglected Markedly Displaced Medial Epicondyle Fracture with Simultaneous Ulnar Nerve Palsy in an Adolescent.
[So] Source:Clin Orthop Surg;9(4):542-546, 2017 Dec.
[Is] ISSN:2005-4408
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Humeral medial epicondyle fractures constitute around 15% of pediatric elbow fractures. Up to 60% occur in association with elbow dislocations. Knowledge of potential imaging pitfalls when examining acute elbow fractures in children contributes significantly to accurate diagnosis. Nevertheless, management of missed pediatric medial epicondyle fractures has rarely been reported. We present an 11-year-old boy with a neglected and severely displaced medial epicondyle fracture with concurrent ulnar nerve palsy. We performed neural decompression, fragment excision, and muscular and capsuloligamentous reconstruction of the medial elbow. This study demonstrates that the surgical outcome of a late presenting fracture can be satisfactory in terms of function and neural recovery. It also underscores the importance of careful interpretation of elbow imaging including normal anatomic variants.
[Mh] Termos MeSH primário: Articulação do Cotovelo/cirurgia
Fraturas do Úmero/complicações
Fraturas do Úmero/cirurgia
Neuropatias Ulnares/complicações
Neuropatias Ulnares/cirurgia
[Mh] Termos MeSH secundário: Criança
Diagnóstico Tardio
Erros de Diagnóstico
Articulação do Cotovelo/lesões
Epífises
Seres Humanos
Fraturas do Úmero/diagnóstico por imagem
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE
[do] DOI:10.4055/cios.2017.9.4.542


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[PMID]:29182131
[Au] Autor:Begovic N; Paunovic Z; Djuraskovic Z; Lazovic L; Mijovic T; Babic S
[Ti] Título:Lateral pinning versus others procedures in the treatment of supracondylar humerus fractures in children.
[So] Source:Acta Orthop Belg;82(4):866-871, 2016 Dec.
[Is] ISSN:0001-6462
[Cp] País de publicação:Belgium
[La] Idioma:eng
[Ab] Resumo:We compared results of lateral pinning procedure with crossed pinning, closed reduction, and open reduction in a retrospective review of 184 patients with displaced supracondylar humeral fractures. All patients had a minimum of 2 years follow-up (range 36-90 months). Patients were separated into 4 groups. Success was estimated by Flynn's criteria. We compared success of the lateral pinning to others procedures. Incidence of nerve palsy was recorded and compared. Esthetic effect of lateral pinning is significantly better than closed reduction (p=0.0007), but no significant difference was found comparing with cross pinning and open reduction. Elbow function was similar. Cross pinning procedure was followed with ulnar nerve palsy in ten patients (20.8%). There was 1 case (5%) of combined nerve palsy including ulnar, median and radial nerve after open reduction procedure. Lateral pinning is safe and effective method of therapy for Gartland type II and III supracondylar humeral fractures.
[Mh] Termos MeSH primário: Pinos Ortopédicos
Articulação do Cotovelo/lesões
Fixação Interna de Fraturas/métodos
Fraturas do Úmero/cirurgia
Doenças do Sistema Nervoso Periférico/epidemiologia
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Redução Fechada/métodos
Articulação do Cotovelo/cirurgia
Feminino
Seres Humanos
Incidência
Masculino
Neuropatia Mediana/epidemiologia
Redução Aberta/métodos
Neuropatia Radial/epidemiologia
Estudos Retrospectivos
Neuropatias Ulnares/epidemiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171228
[Lr] Data última revisão:
171228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


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[PMID]:28753608
[Au] Autor:Bathala L; N Krishnam V; Kumar HK; Neladimmanahally V; Nagaraju U; Kumar HM; Telleman JA; Visser LH
[Ad] Endereço:Department of Neurology, Aster CMI Hospital, Bangalore, India.
[Ti] Título:Extensive sonographic ulnar nerve enlargement above the medial epicondyle is a characteristic sign in Hansen's neuropathy.
[So] Source:PLoS Negl Trop Dis;11(7):e0005766, 2017 Jul.
[Is] ISSN:1935-2735
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Earlier studies have shown sonographic enlargement of the ulnar nerve in patients with Hansen's neuropathy. The present study was performed to determine whether sonography or electrophysiological studies can detect the specific site of ulnar nerve pathology in leprosy. METHODS: Eighteen patients (thirty arms) with Hansen's disease and an ulnar neuropathy of whom 66% had borderline tuberculoid (BT), 27% lepromatous leprosy (LL) and 7% mid-borderline (BB) leprosy were included in the study. Cross-sectional area (CSA) of ulnar nerve was measured every two centimeters from wrist to medial epicondyle and from there to axilla. All patients underwent standard motor and sensory nerve conduction studies of the ulnar nerve. Thirty age and sex matched controls underwent similar ulnar nerve CSA measurements and conduction studies. RESULTS: Ulnar nerve was clinically palpable in 19 of the 30 arms of patients. Motor and sensory nerve conduction studies of the ulnar nerve showed a reduced compound motor action potential and sensory nerve action potential amplitude in all patients. Motor Conduction Velocity (MCV) in patients were slower in comparison to controls, especially at the elbow and upper arm, but unable to exactly locate the site of the lesion. In comparison to controls the ulnar nerveCSA was larger in the whole arm in patients and quite specific the maximum enlargement was seen between nulnar sulcus and axilla, peaking at four centimeters above the sulcus. CONCLUSIONS: A unique sonographic pattern of nerve enlargement is noted in patients with ulnar neuropathy due to Hansen's disease, while this was not the case for the technique used until now, the electrodiagnostic testing. The enlargement starts at ulnar sulcus and is maximum four centimeters above the medial epicondyle and starts reducing further along the tract. This characteristic finding can help especially in diagnosing pure neuritic type of Hansen's disease, in which skin lesions are absent, and alsoto differentiate leprosy from other neuropathies in which nerve enlargement can occur.
[Mh] Termos MeSH primário: Cotovelo/diagnóstico por imagem
Hanseníase/complicações
Hanseníase/diagnóstico por imagem
Nervo Ulnar/fisiopatologia
Neuropatias Ulnares/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Estudos de Casos e Controles
Eletrofisiologia
Feminino
Seres Humanos
Modelos Lineares
Masculino
Meia-Idade
Países Baixos
Condução Nervosa
Exame Neurológico
Nervo Ulnar/diagnóstico por imagem
Ultrassonografia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170729
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0005766


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[PMID]:28578770
[Au] Autor:Bindra RR
[Ad] Endereço:Griffith University School of Medicine, Gold Coast University Hospital, Southport, Australia.
[Ti] Título:Commentary on "Compressive Neuropathy of the Ulnar Nerve: A Perspective on History and Current Controversies".
[So] Source:J Hand Surg Am;42(6):470, 2017 06.
[Is] ISSN:1531-6564
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Nervo Ulnar
Neuropatias Ulnares
[Mh] Termos MeSH secundário: Artrogripose
Neuropatia Hereditária Motora e Sensorial
Seres Humanos
Síndromes de Compressão Nervosa
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171101
[Lr] Data última revisão:
171101
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170606
[St] Status:MEDLINE


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[PMID]:28319875
[Au] Autor:Karakis I; Liew W; Fournier HS; Jones HR; Darras BT; Kang PB
[Ad] Endereço:Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA; Department of Neurology, Lahey Clinic, Burlington, MA, USA; Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
[Ti] Título:Electrophysiologic features of ulnar neuropathy in childhood and adolescence.
[So] Source:Clin Neurophysiol;128(5):751-755, 2017 May.
[Is] ISSN:1872-8952
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To analyze patterns of nerve injury in pediatric ulnar neuropathy (PUN). METHODS: Retrospective analysis of 49 children with PUN. RESULTS: Sensory loss in digit V was the prevailing complaint (89%). Predominant localization was at the elbow (55%). Diminished ulnar SNAP was the most common abnormality (71%) with median axon loss estimate (MAXE) of 62%. Dorsal ulnar cutaneous (DUC) sensory nerve action potential (SNAP) was reduced in 55% with MAXE of 43%. Abductor digiti minimi (ADM) and first dorsal interosseous (FDI) compound muscle action potential (CMAP) were reduced half of the time, with MAXE of 30% and 28% respectively. There was high correlation between ulnar sensory MAXE and ADM MAXE (r=0.76, p<0.0001), FDI MAXE (r=0.81, p<0.0001) and DUC MAXE (r=0.60, p=0.0048). Neurogenic changes were seen in the ADM, FDI, flexor carpi ulnaris (FCU) and flexor digitorum profundus IV (FDP IV) in 79%, 77%, 25% and 35% respectively. Pathophysiology was demyelinating in 27%, axonal in 59% and mixed in 14%. CONCLUSIONS: In proximal axonal lesions, sensory fibers to digit V and motor fibers to distal muscles are predominantly affected, whereas in demyelinating lesions, slowing occurs twice as frequently as conduction block. SIGNIFICANCE: There is frequent axonal and fascicular injury in PUN.
[Mh] Termos MeSH primário: Potenciais de Ação
Neuropatias Ulnares/fisiopatologia
[Mh] Termos MeSH secundário: Adolescente
Axônios/patologia
Axônios/fisiologia
Criança
Feminino
Seres Humanos
Masculino
Neurônios Motores/patologia
Neurônios Motores/fisiologia
Músculo Esquelético/crescimento & desenvolvimento
Músculo Esquelético/inervação
Bainha de Mielina/patologia
Tempo de Reação
Nervo Ulnar/fisiopatologia
Neuropatias Ulnares/patologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170530
[Lr] Data última revisão:
170530
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170321
[St] Status:MEDLINE


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[PMID]:28251323
[Au] Autor:Balikova M; Neklanova M; Sulla I; Hönig M; Halek J; Mihal V; Balik V
[Ad] Endereço:Department of Pediatrics, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic.
[Ti] Título:Bilateral position-related ulnar neuropathy at elbow in pediatric population and review of the literature.
[So] Source:Childs Nerv Syst;33(3):399-405, 2017 Mar.
[Is] ISSN:1433-0350
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Perioperative ulnar neuropathies attributed to inappropriate arm positioning and padding during surgical procedures are commonly found in adults. However, their extremely rare incidence in the pediatric population may cause absent awareness of the risk of nerve injury in anesthetized pediatric patients. Furthermore, young patients respond to conservative treatment of neuropathy less favorably than adults and their response also depends on the pathomechanism of the ulnar nerve injury. A surgeon's or anesthetist's failure to recognize all of these specifics in children may result in substantial morbidity of young patients leading to lawsuits. Fortunately, with an adequate knowledge of surgical anatomy and types of procedures and positions in which the ulnar nerve is particularly vulnerable, and familiarity with measures to minimize the potential for neuropathy, this serious complication can be prevented. The aims of this review are to highlight personal experience and current knowledge of the rare position-related ulnar neuropathy, both from a clinical and anatomical-pathophysiological perspective, and to raise awareness about this rare but serious complication in the pediatric population.
[Mh] Termos MeSH primário: Cotovelo/inervação
Cotovelo/patologia
Neuropatias Ulnares
[Mh] Termos MeSH secundário: Gerenciamento Clínico
Seres Humanos
Pediatria
Neuropatias Ulnares/patologia
Neuropatias Ulnares/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170303
[St] Status:MEDLINE
[do] DOI:10.1007/s00381-017-3347-8


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[PMID]:28245664
[Au] Autor:van Gent JA; Datema M; Groen JL; Pondaag W; Eekhof JL; Malessy MJ
[Ad] Endereço:Departments of 1 Neurosurgery and.
[Ti] Título:Anterior subcutaneous transposition for persistent ulnar neuropathy after neurolysis.
[So] Source:Neurosurg Focus;42(3):E8, 2017 Mar.
[Is] ISSN:1092-0684
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE Little is known about optimal treatment if neurolysis for ulnar nerve entrapment at the elbow fails. The authors evaluated the clinical outcome of patients who underwent anterior subcutaneous transposition after failure of neurolysis of ulnar nerve entrapment (ASTAFNUE). METHODS A consecutive series of patients who underwent ASTAFNUE performed by a single surgeon between 2009 and 2014 was analyzed retrospectively. Preoperative and postoperative complaints in the following 3 clinical modalities were compared: pain and/or tingling, weakness, and numbness. Six-point satisfaction scores were determined on the basis of data from systematic telephonic surveys. RESULTS Twenty-six patients were included. The median age was 56 years (range 22-79 years). The median duration of complaints before ASTAFNUE was 23 months (range 8-78 months). The median interval between neurolysis and ASTAFNUE was 11 months (range 5-34 months). At presentation, 88% of the patients were experiencing pain and/or tingling, 46% had weakness, and 50% had numbness of the fourth and fifth fingers. Pain and/or tingling improved in 35%, motor function in 23%, and sensory disturbances in 19% of all the patients. Improvement in at least 1 of the 3 clinical modalities was found in 58%. However, a deterioration in 1 of the 3 modalities was noted in 46% of the patients. On the patient-satisfaction scale, 62% reported a good or excellent outcome. Patients with a good/excellent outcome were a median of 11 years younger than patients with a fair/poor outcome. No other factor was significantly related to satisfaction score. CONCLUSIONS A majority of the patients were satisfied after ASTAFNUE, even though their symptoms only partly resolved or even deteriorated. Older age is a risk factor for a poor outcome. Other factors that affect outcome might play a role, but they remain unidentified. One of these factors might be earlier surgical intervention. The modest results of ASTAFNUE should be mentioned when counseling patients after failure of neurolysis of ulnar nerve entrapment to manage their expectations. Patients, especially those who are elderly, might even consider not undergoing a secondary procedure. A randomized trial that includes a conservative treatment group and groups undergoing one of the several possible surgical procedures is needed to find the definitive answer for this clinical problem.
[Mh] Termos MeSH primário: Descompressão Cirúrgica/métodos
Bloqueio Nervoso/tendências
Síndromes de Compressão do Nervo Ulnar/cirurgia
Neuropatias Ulnares/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Falha de Tratamento
Resultado do Tratamento
Síndromes de Compressão do Nervo Ulnar/diagnóstico
Neuropatias Ulnares/diagnóstico
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170308
[Lr] Data última revisão:
170308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170302
[St] Status:MEDLINE
[do] DOI:10.3171/2016.11.FOCUS16451


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[PMID]:28142173
[Ti] Título:Ulnare Neuropathie: Luxation des Nervs nicht ursächlich?.
[So] Source:Rofo;189(2):113, 2017 Feb.
[Is] ISSN:1438-9010
[Cp] País de publicação:Germany
[La] Idioma:ger
[Mh] Termos MeSH primário: Erros de Diagnóstico/prevenção & controle
Imagem por Ressonância Magnética/métodos
Traumatismos dos Nervos Periféricos/diagnóstico por imagem
Nervo Ulnar/diagnóstico por imagem
Nervo Ulnar/lesões
Neuropatias Ulnares/diagnóstico por imagem
[Mh] Termos MeSH secundário: Diagnóstico Diferencial
Feminino
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170201
[St] Status:MEDLINE
[do] DOI:10.1055/s-0042-122090


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[PMID]:28089807
[Au] Autor:Pisapia JM; Ali ZS; Hudgins ED; Khoury V; Heuer GG; Zager EL
[Ad] Endereço:Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Electronic address: Jared.Pisapia@uphs.upenn.edu.
[Ti] Título:Ultrasonography Detects Ulnar Nerve Dislocation Despite Normal Electrophysiology and Magnetic Resonance Imaging.
[So] Source:World Neurosurg;99:809.e1-809.e5, 2017 Mar.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Dislocation of the ulnar nerve (UN) occurs in a subset of patients with ulnar neuropathy. Electrodiagnostic and magnetic resonance imaging (MRI) studies are performed to support the clinical diagnosis. We report the case of a patient with ulnar neuropathy with normal electrodiagnostic and MRI studies but with ultrasonography (US) showing UN dislocation, which prompted successful treatment by UN submuscular transposition. CASE DESCRIPTION: A healthy 15-year-old female softball player presented with right medial elbow pain and paresthesias of the fourth and fifth digits. She had 4+/5 strength in the right hand intrinsic muscles and a Tinel sign at the right elbow. A snap was palpated at the elbow upon flexion. MRI showed mild common flexor tendonitis, and electrodiagnostic studies showed normal motor responses and no conduction block at the elbow. High-resolution US showed dislocation of the UN over the medial epicondyle. UN dislocation was confirmed intraoperatively, and, after UN submuscular transposition, the patient reported complete resolution of her preoperative symptoms at 6-week follow-up and continued resolution at 1 year. CONCLUSIONS: Normal findings on electrodiagnostic or MRI studies should not immediately dissuade surgeons from operating on a symptomatic patient with a clinical examination supporting ulnar neuropathy and with US evidence of UN dislocation, because such a patient may experience postoperative symptom relief. Furthermore, the dynamic capability of US imaging complements data obtained from electrodiagnostic and MRI studies, especially when these tests are normal, and it should be considered by clinicians when evaluating patients with medial elbow pain or signs of ulnar neuropathy.
[Mh] Termos MeSH primário: Cotovelo/diagnóstico por imagem
Nervo Ulnar/diagnóstico por imagem
Neuropatias Ulnares/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adolescente
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Condução Nervosa
Ultrassonografia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170117
[St] Status:MEDLINE



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