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Neurolysis of the ulnar nerve for neuropathy following total elbow replacement

¹ Wilford Hall Medical Center, 220 Berquist Drive, Suite 1, Lackland Air Force Base, Texas 78236, USA.
² University of Western Ontario, 268 Grosvenor Street, London, Ontario, Canada N6A 4L6.
³ Mayo Clinic, 200 First Street, SW Rochester, Minnesota 55905, USA.

Correspondence should be sent to Lt Col D. M. Rispoli; e-mail: Damian.rispoli{at}lackland.af.mil

Ulnar neuropathy presents as a complication in 5% to 10% of total elbow replacements, but subsequent ulnar neurolysis is rarely performed. Little information is available on the surgical management of persistent ulnar neuropathy after elbow replacement. We describe our experience with the surgical management of this problem.

Of 1607 total elbow replacements performed at our institution between January 1969 and December 2004, eight patients (0.5%) had a further operation for persistent or progressive ulnar neuropathy. At a mean follow-up of 9.2 years (3.1 to 21.7) six were clinically improved and satisfied with their outcome, although, only four had complete recovery. When transposition was performed on a previously untransposed nerve the rate of recovery was 75%, but this was reduced to 25% if the nerve had been transposed at the time of the replacement.