Management of the Ulnar Nerve in Surgery for Distal Humerus Fracture: A Case of Ulnar Neuropathy Development Following Open Reduction and Internal Fixation

Asia Pacific Orthopaedic Association, Dubai, Birleşik Arap Emirlikleri, 29 Şubat - 02 Mart 2024, ss.147, (Tam Metin Bildiri)

This case report examines the development of postoperative ulnar neuropathy symptoms and persistent nonunion in a patient

who underwent surgery for a distal humerus fracture. The study aims to explore the relationship between nonunion and the

subsequent development of ulnar neuropathy, prompting a discussion on the necessity of ulnar nerve care, including

transposition, manipulation, or decompression, during distal humerus fracture surgeries. A 52-year-old man with a bi-

columnar distal humerus fracture, resulting from a fall on his right elbow, underwent open reduction and internal fixation at

an external center one year prior. Eight months post-surgery, the patient reported elbow restriction, discomfort, numbness,

and weakness in the fourth and fifth digits of the right hand. Radiological exams revealed nonunion in the distal right

humerus. Notably, the patient had no signs of ulnar neuropathy before the injury. In the eighth month following the injury,

the patient underwent implant removal, open reduction internal fixation with autograft, and ulnar nerve transposition.

Subsequent follow-up revealed a resolution of ulnar neuropathy symptoms. The case emphasizes the importance of the

surgeon's expertise in managing the ulnar nerve during distal humerus fractures and underscores the need for further

research to establish the link between ulnar neuropathy onset and nonunion in the treatment of such fractures.