Ulnar neuropathy following distal humerus fracture fixation.

Ulnar nerve dysfunction is a well-recognized phenomenon following distal humerus fractures. Its fixed anatomic position predisposes the nerve to injury. Injury can occur at the time of injury, during closed-fracture manipulation, intraoperatively during fracture fixation (when it is routinely identified), or during fracture healing. Intraoperative management varies widely and can include in situ decompression or anterior transposition. This article reviews the literature and presents 24 patient cases. A 38% incidence of late ulnar neuropathy following open reduction and internal fixation is identified. There is no statistical difference between an in situ release and all anterior transpositions, except for submuscular.