Prevalence of Ulnar Artery Thrombosis in Orthopedic Surgeons

Abstract

Ulnar artery thrombosis (UAT) occurs most commonly in athletes and manual laborers who repeatedly use their palm in high-impact activities. Anecdotal evidence has shown an increased prevalence of UAT in orthopedic surgeons, especially in joint arthroplasty surgeons, compared with the general population. This study sought to determine the prevalence of UAT among orthopedic surgeons and to identify risk factors for developing UAT. Eighty orthopedic surgeons and residents were included in the study. Participants completed a demographic questionnaire, and a timed Allen test was performed on each hand with the radial artery occluded. A reperfusion result greater than 6 seconds was considered abnormal. Participants with a positive Allen test and UAT-associated symptoms were deemed to have UAT. Statistical analysis was performed using the Fisher exact and Wilcox-on rank-sum tests. The prevalence of UAT was 11% (9 of 80) in the study population compared with 1.6% (21 of 1300) in the general population (P<.0001). For surgeons with 15 years or more of practice, the UAT rate was 24% (8 of 33) compared with 2% (1 of 47) for surgeons with less than 15 years of practice (P=.0030). The prevalence of UAT in adult reconstruction surgeons trended toward significance at 40% (2 of 5) compared with 9% (7 of 75) in the other subspecialties (P=.095). Orthopedic surgeons have an increased risk for developing UAT compared with the general population. The risk of UAT is significantly correlated with advancing years in clinical practice and may be associated with the number of arthroplasty cases performed. [Orthopedics. 2019; 42(5):e415-e422.].