Ulnar neuropathy in surgical patients

Background: The goal of this project was to study the frequency and natural history of perioperative ulnar neuropathy. Methods: A prospective evaluation of ulnar neuropathy in 1,502 adult patien ts undergoing noncardiac surgical procedures was performed Patients were as sessed with a standard questionnaire and neurologic examination before surg ery, daily during hospitalization in the first week after surgery, and by t elephone if they were discharged before 1 postoperative week Patients in wh om ulnar neuropathy developed were followed for 2 yr. Results: Ulnar neuropathy developed in seven patients (0.5%; 95% confidence interval, 0.2% to 1.0%). Six of the seven patients were men. Symptoms of u lnar neuropathy began 2-7 days after surgery. Manifestations were mild and confined to sensory deficits in six patients. Symptoms resolved in four pat ients within 6 weeks. The remaining three patients had residual symptoms 2 yr later. Conclusions: In this surgical population, ulnar neuropathy was an infrequen t complication. It occurred primarily in men who were 50-75 yr old and was not symptomatic until several days after surgery. Gender-dependent differen ces in the anatomy of the ulnar nerve and related structures at the elbow m ay serve as risk factors for ulnar neuropathy in patients having surgery.