SURGICAL TREATMENT OF ULNAR NERVE LESIONS AT THE LEVEL OF THE ULNAR JOINT

Abstract

In almost all cases of lesions of the osteoarticular apparatus at the level of the elbow joint, the ulnar nerve is affected too nedegree or another. The results of surgical treatment of 71 patients with ulnar nerve damage at the level of the joint of the same name, operated on in the period from 2017 to 2024, were analyzed. The majority of patients – 59 (83%) were men, 12 (17%) were women. The patients ranged in age from 20 to 66 years, mainly in the range of 30-59years, making up 55 (77.4%) patients. Household and street trauma prevailed in 55 (77.4%). The majority of patients – 42 (59.1%) – had closed lesions. In 16 (22.5%) cases, ulnar nerve injury occurred with open injury, 13 (18.3%) injuries were of iatrogenic etiology. Neurolysis and anterior subcutaneous ulnar nerve transposition for tunnel neuropathy were performed in 45 patients, suture was applied in 10 patients, and autoplasty was performed in three patients. Anterior subcutaneous nerve transposition was performed in all operated patients in order to reduce diastasis between the ends of the nerve. The result safter the operations performed on the international six-point scale MS0-5 allowed to raise the indicators M4-M5 from19.7% to 67.6%, S4–S5-from 19.7% to 60.6%. Anterior transposition of the ulnar nerve with its closure with a soft tissue-fatflapis the optimal solution for compression neuropathy and nerve suture. In case of intraarticular fractures with both bone fragments and iatrogenic causes, it is recommended to simultaneously perform anterior subcutaneous nerve transposition during osteosynthesis surgery.