Perioperative ulnar neuropathies attributed to inappropriate arm positioning and padding during surgical procedures are commonly found in adults. However, their extremely rare incidence in the pediatric population may cause absent awareness of the risk of nerve injury in anesthetized pediatric patients. Furthermore, young patients respond to conservative treatment of neuropathy less favorably than adults and their response also depends on the pathomechanism of the ulnar nerve injury. A surgeon's or anesthetist's failure to recognize all of these specifics in children may result in substantial morbidity of young patients leading to lawsuits. Fortunately, with an adequate knowledge of surgical anatomy and types of procedures and positions in which the ulnar nerve is particularly vulnerable, and familiarity with measures to minimize the potential for neuropathy, this serious complication can be prevented. The aims of this review are to highlight personal experience and current knowledge of the rare position-related ulnar neuropathy, both from a clinical and anatomical-pathophysiological perspective, and to raise awareness about this rare but serious complication in the pediatric population.

Department of Neurosurgery University Hospital Olomouc and Faculty of Medicine and Dentistry Palacky University 1 P Pavlova 6 775 20 Olomouc Czech Republic

Department of Pediatrics University Hospital Olomouc and Faculty of Medicine and Dentistry Palacky University 1 P Pavlova 6 775 20 Olomouc Czech Republic

Department of Surgery Hospital of Slovak Railways and Institute of Neurobiology Slovak Academy of Sciences Soltesovej 4 040 01 Kosice Slovak Republic

Neurofyz Ltd Neurological clinic and EMG laboratory Prerov Czech Republic

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