Management of Tardy Ulnar Nerve Palsy in A Tertiary Level Hospital

Open Access

Abstract

Background: Tardy ulnar nerve palsy is a delayed ulnar neuropathy that usually develops years after elbow trauma or cubitus valgus deformity due to neglected lateral condyle fracture nonunion, leading to sensory and motor dysfunction of the hand. Aim of the study: This study aimed to evaluate the management of tardy ulnar nerve palsy at a tertiary-level hospital. Methods & Materials: This hospital-based retrospective study was conducted in the Department of Orthopedics, Monno Medical College Hospital, Manikgonj, Bangladesh, from January to December 2025 and included 28 selected patients with tardy ulnar nerve palsy. Clinical, radiological, and electrophysiological data were collected using a structured form, and patients underwent appropriate surgical management with postoperative assessment of complications and final outcome. Results: Among 28 patients, the mean age was 32.8 ± 11.6 years, and 71.4% were male. The most common etiology was neglected or non-united lateral condyle fracture, 64.3%, while 82.1% had elbow deformity. Sensory symptoms predominated, particularly numbness in the ring and little fingers (96.4% and 89.3%, respectively); nerve conduction study was abnormal in 92.9%. Subcutaneous anterior transposition (53.6%) was the most common procedure, and 75.0% of patients achieved an excellent or good final outcome. Conclusion: Tardy ulnar nerve palsy was mainly related to post-traumatic elbow deformity, especially neglected lateral condyle fracture nonunion. Most patients had longstanding neurological deficits, and surgical treatment resulted in favorable outcomes in most cases, with better sensory than motor recovery.