♦ 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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