Ulnar nerve function following total elbow arthroplasty: A prospective study comparing preoperative and postoperative clinical and electrophysiologicevaluation in patients with rheumatoid arthritis

A study was conducted to determine the incidence of ulnar and peripheral ne uropathy in patients with rheumatoid arthritis undergoing total elbow arthr oplasty and the effect it has on ulnar nerve function after surgery. Preope rative and postoperative clinical and electrodiagnostic examinations were c ompleted in 10 patients. Before surgery 4 patients had clinical and electro physiologic evidence of a neuropathy (2 each with a peripheral neuropathy a nd an ulnar neuropathy). One patient had subclinical evidence of a chronic T-1 radiculopathy. After surgery 2 patients showed neurologic improvement ( 1 had ulnar neuropathy and 1 had diabetic neuropathy). One patient who had normal test results before surgery developed transient ulnar sensory sympto ms after surgery. An electrodiagnostic study confirmed an ulnar neuropathy that was not detected on physical examination; the electrodiagnostic findin gs improved 4 months later. We found that a large percentage of patients (4 0%) with rheumatoid arthritis had evidence of ulnar or peripheral neuropath y before surgery. The presence of an ulnar or peripheral neuropathy did not predispose patients to develop postoperative ulnar nerve dysfunction eithe r clinically or electrophysiologically. Preoperative and postoperative phys ical and electrodiagnostic examination results correlated in 9 of the 10 pa tients. (J Hand Surg 2000;25A:360-364. Copyright (C) 2000 by the American S ociety for Surgery of the Hand.).