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December 18, 1981

Postoperative Ulnar Neuropathy-Reply

Author Affiliations

Midwest Clinic Omaha

JAMA. 1981;246(24):2807. doi:10.1001/jama.1981.03320240016010

In Reply.—  The comments of Drs Mawk and Thienprasit are appreciated. Other factors contributing to postoperative left ulnar nerve compression neuropathy, besides position and time, include low pulse pressure, the depth of the ulnar groove-cubital tunnel, and the anatomy of the ulnar groove-cubital tunnel.The low pulse pressure that occurs during open heart surgery results in decreased perfusion generally and particularly to the already compressed ulnar nerve at the level of the ulnar groove-cubital tunnel. Local ischemia, which is the basic underlying pathological mechanism, may be worsened by the low pulse pressure and resultant decreased systemic vascular perfusion that accompanies open heart surgery.During the early 1960s at the University of Nebraska Medical College, a study of 100 cadavers undertaken to measure the depth of the ulnar groove-cubital tunnel found that the depth depended on the height of the medial epicondyle. It was reasoned that the ulnar nerve would be