The Effect On Ulnar Nerve Function After Open Elbow Arthrolysis

Objective: Elbow stiffness is a common complication after trauma,and surgical release is currently the usual treatment.Elbow trauma,including initial trauma and surgical trauma,is likely to cause ulnar nerve injury,which in turn produces ulnar neuropathy.How to effectively protect the ulnar nerve in the surgical treatment of elbow stiffness and repair the ulnar nerve that has caused the injury symptoms is a key point in clinical treatment.The purpose of this study was to investigate the effects on elbow and ulnar nerve function of patients after open elbow arthrolysis,including patients with preoperative ulnar nerve symptoms and patients without preoperative ulnar nerve symptoms.Two types of operation of ulnar nerve will be discussed.In addition,factors related to the prognosis of the ulnar nerve will be discussed.Methods: 118 patients who underwent open elbow arthrolysis in our hospital from January 2015 to October 2017 were reviewed.The patient’s general condition and the recovery of the ulnar nerve and ulnar nerve function were analyzed.The patients were divided into two groups according to the preoperative ulnar nerve symptoms.The recovery of the elbow joint and ulnar nerve function and the related factors affecting the ulnar nerve function were analyzed respectively.According to whether do anterior transposition of ulnar nerve or not,the patients was subdivided into two groups.The prognosis of the elbow joint and ulnar nerve function between the two groups was compared.The effect on elbow and ulnar nerve functions of two types of patients caused by two kind of operations will thus be discussed.Results: After 1 year’s follow-up,the results showed that after open elbow arthrolysis,the elbow joint extension,flexion,range of motion,pre-rotation,supination,forearm rotation,Mayo elbow function score,VAS Pain scores and Amadio ulnar nerve damage scores were significantly improved(P<0.05).For patients without preoperative ulnar nerve symptoms,ulnar nerve in situ detachment or ulnar nerve anterior transposition has no significant difference in the prognosis of elbow and ulnar nerve function.For patients with preoperative ulnar nerve symptoms,the improvement of elbow joint mobility was better in patients of anterior transposition group than that of ulnar nerve in situ group(P<0.05).The difference in the improvement of ulnar nerve function was not obvious.Age and preoperative ulnar nerve symptoms are independent risk factors for ulnar nerve function.Conclusion: Open elbow arthrolysis can improve the elbow function and ulnar nerve function in the long-term.For patients with preoperative ulnar nerve symptoms,the ulnar nerve function can be restored.Anterior or in situ placement of the ulnar nerve has no significant effect on the prognosis of the elbow joint and ulnar nerve function.For patients with preoperative ulnar nerve symptoms,most of the ulnar nerve function can be improved in the long-term.The anterior position of ulnar nerve has a greater function improvement for the elbow joint,but has no significant effect on the function of the ulnar nerve itself.The older the patient,the worse the prognosis of the ulnar nerve.