Late ulnar neuropathy in the brain-injured adult.
Twenty-five brain-injured adults who were treated for tardy ulnar neuropathy during a 5-year period were studied. Two patients had bilateral involvement. The incidence of late ulnar neuropathy in this population was determined to be 2.5%. The ulnar neuropathy was always on the neurologically impaired side and associated with significant spasticity. Diagnosis was made when intrinsic atrophy was noted in the hand. No patient initiated a subjective complaint. Nerve conduction velocity measurements confirmed impingement of the ulnar nerve in the cubital canal in 16 cases. Twenty-one of the 27 (78%) elbows had moderate to severe heterotopic ossification causing impingement of the ulnar nerve. All patients were treated by anterior transposition of the ulnar nerve. Follow-up averaged 22.7 months. Twenty-three (85%) extremities had complete recovery of ulnar nerve function. Four patients had improved but incomplete recovery of function. Prolonged compression of the nerve led to incomplete recovery.
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000150:complications* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009128:Muscle Spasticity / Q000209:etiology; D009408:Nerve Compression Syndromes / Q000209:etiology* / Q000601:surgery; D009431:Neural Conduction; D009999:Ossification, Heterotopic / Q000150:complications; D010243:Paralysis / Q000209:etiology / Q000601:surgery; D013997:Time Factors; D014459:Ulnar Nerve / Q000601:surgery