Evidence map›Paper›PMID 34028572›Full record

ArticleInternational orthopaedics2021

Epineurotomy for leprous, high ulnar neuropathy: defining a safe corridor based on the epineural vascular anatomy.

Anil Dhal, Yasim Khan, Sumit Arora

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Article in International orthopaedics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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3 authors at 2 institutions in 1 country.

Anil DhalDepartment of Orthopaedics, ESIC Medical College & Hospital, Faridabad, Haryana, India.
Yasim KhanDepartment of Orthopaedic Surgery, The Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi, 110002, India.
Sumit AroraDepartment of Orthopaedic Surgery, The Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi, 110002, India. mamc_309@yahoo.co.in.ORCID http://orcid.org/0000-0002-0321-1407
Maulana Azad Medical College · INESIC Hospital · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLeprous neuropathy is treatable but still a source of disability worldwide. Multidrug therapy (MDT) and oral steroids are the main stay of treatment. Ulnar nerve, at the elbow, is commonly involved. Nerve decompression may be required in selected cases by an epineurotomy (internal neurolysis). The preferred surface of ulnar nerve for performing this procedure to minimize iatrogenic vascular compromise is a matter of debate. QUESTIONS/PURPOSES: We describe the epineural vessel arrangement on the medial and lateral surface of ulnar nerve around the medial epicondyle while performing epineurotomy for leprous neuropathy.

methodsWe enrolled patients of symptomatic leprous ulnar neuropathy of less than one year duration on MDT that did not respond to steroids, for surgical decompression. Ten patients underwent epineurotomy of ulnar nerves (N = 11) around medial epicondyle. The epineural vessels were classified as per Sunderland's classification of arteriae nervorum. The number of epineural vessels was assessed on the medial and lateral surface of the ulnar nerve adjoining the medial epicondyle. The epineurotomy incision was placed over the surface of ulnar nerve having relatively less vessels.

resultsThe mean number of epineural vessels on the medial surface was 9.72 (range; 7-14) and on the lateral surface were 4.72 (range; 3-6). The average number of vessels per cm

conclusionLateral surface (facing the medial epicondyle) of ulnar nerve has a lesser density of epineural vessels in comparison to its medial (subcutaneous) surface. CLINICAL RELEVANCE: This anatomical understanding may be helpful in minimizing the iatrogenic vascular compromise of ulnar nerve while performing its epineurotomy around the medial epicondyle for leprous neuropathy. The findings may be extrapolated to other clinical indications of epineurotomy of ulnar nerve, for example, in cubital tunnel syndrome, traumatic ulnar neuroma in continuity, and benign ulnar nerve tumors.

Indexed as

Cubital Tunnel SyndromeLeprostatic AgentsDecompression, SurgicalDrug Therapy, CombinationElbowHumansUlnar NerveLeprostatic AgentsEpineurotomy incisionInternal neurolysisLeprous neuropathyNerve decompressionUlnar nerve

Identifiers

PMID34028572
OpenAlexW3164512275

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