Ulnar Nerve Decompression

152 Ulnar Nerve Decompression
Christopher J. Winfree


♦ Preoperative


Special Equipment



  • Basic tray

Operating Room Set-up



  • Headlight
  • Loupes

Anesthetic Issues



  • Monitored anesthesia care in most cases of simple decompression; regional blocks are preferred by some practitioners and/or institutions
  • Perioperative antibiotics (first generation cephalosporin)
  • Pad patient appropriately.

Miscellaneous



  • A simple decompression is generally appropriate for all patients as a first procedure; some practitioners prefer to begin with a transposition procedure rather than a simple decompression when preoperative examination reveals an ulnar nerve that translocates out of the ulnar groove during elbow flexion.
  • If the patient’s condition fails to improve several months following a simple decompression, then a submuscular decompression may be used as a bailout procedure.

♦ Intraoperative (Fig. 152.1)


Positioning



  • Patient is supine with arm on an armboard
  • Securing the outstretched arm at 90 degrees in a position of supination with the elbow flexed at 90 degrees allows the surgeon to easily approach the ulnar groove.

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Jul 11, 2016 | Posted by in NEUROSURGERY | Comments Off on Ulnar Nerve Decompression

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