title: Bilateral position-related ulnar neuropathy at elbow in pediatric population and review of the literature.
abstract: 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.
authors.affiliation: Department of Pediatrics, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic.
authors.forename: Mariana
authors.initials: M
authors.lastname: Balikova
authors.affiliation: Department of Pediatrics, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic.
authors.forename: Marta
authors.initials: M
authors.lastname: Neklanova
authors.affiliation: Department of Surgery, Hospital of Slovak Railways and Institute of Neurobiology, Slovak Academy of Sciences, Soltesovej 4, 040 01, Kosice, Slovak Republic.
authors.forename: Igor
authors.initials: I
authors.lastname: Sulla
authors.affiliation: Neurofyz Ltd., Neurological clinic and EMG laboratory, Prerov, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Hönig
authors.affiliation: Department of Pediatrics, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Halek
authors.affiliation: Department of Pediatrics, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Mihal
authors.affiliation: Department of Neurosurgery, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University, I. P. Pavlova 6, 775 20, Olomouc, Czech Republic. balik.vladimir@gmail.com.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Balik
mesh_terms: D019468:Disease Management; D004550:Elbow / Q000294:innervation* / Q000473:pathology*; D006801:Humans; D010372:Pediatrics; D020424:Ulnar Neuropathies / Q000473:pathology / Q000628:therapy
keywords: Adolescent; Cubital tunnel syndrome; Pediatric; Position-related; Ulnar neuropathy