Ulnar Neuropathy at the Elbow

Bradshaw, Deborah Young; Shefner, Jeremy M.

doi:10.1016/s0733-8619(05)70147-x

Cited by 58 publications

(38 citation statements)

References 53 publications

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“…[8][9][10]27,29,31,32,[34][35][36]39,42) The initial treatment of acute and subacute neuropathy is conservative. Rest and avoidance of pressure on the nerve may suffice, but if symptoms persist, splint immobilization of the elbow is warranted.…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment for Ulnar Nerve Entrapment at the Elbow

Asamoto

Böker

Jödicke

2005

Neurol. Med. Chir.(Tokyo)

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The outcomes of 81 operations were assessed for the treatment of ulnar nerve entrapment at the elbow performed on 55 males (bilateral operations in one) and 25 females during the period from January 1995 to December 2000. Before operation, neurophysiological examination was performed in all patients. Simple ulnar nerve decompression or anterior transposition of the ulnar nerve (subcutaneous or intramuscular) was performed with or without the operating microscope. Nine patients were lost to follow up. The outcome was excellent or good in 63 of 72 cases, no change in eight cases, and poor in one case. The outcomes of procedures performed with the operating microscope tended to be superior.

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Section: Introductionmentioning

confidence: 99%

Surgical Treatment for Ulnar Nerve Entrapment at the Elbow

Asamoto

Böker

Jödicke

2005

Neurol. Med. Chir.(Tokyo)

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“…Sensory disturbances typically involve the small and ring fingers and can also involve the dorsal-ulnar aspect of the hand if the lesion is proximal to the wrist. 1 Sensory changes can contribute to motor control difficulties or even manifest as a safety issue with severe compression to afferent axons transmitting pain and temperature information. Ulnar nerve motor involvement affects most of the intrinsic hand muscles, excluding three muscles in the thenar eminence and the lumbrical muscles to the index and ring fingers.…”

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confidence: 99%

“…If the entrapment is at the level of the elbow, the flexor digitorum profundus (FDP) to the ring and small fingers and the flexor carpi ulnaris (the strongest wrist flexor) may become weakened. 1 Other symptoms associated with peripheral motor axon involvement include muscle cramps and fasciculations. 2 Chronic entrapment of ulnar nerve motor fibers at the elbow can lead to a loss of dexterity 3 and a decrease in grip and pinch strength, 3 both of which can impact performance of functional activities.…”

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confidence: 99%

“…19 Regardless of the electrodiagnostic findings, results of provocative testing are used for diagnostic purposes, to help assess the severity of ulnar nerve compression and in documenting progression or recovery over a period of time. 1,20 The following ulnar nerve provocative tests are part of a comprehensive upper extremity evaluation for patients with suspected ulnar nerve compression neuropathy and have been summarized in Table 1.…”

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confidence: 99%

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A Review of Clinical Tests and Signs for the Assessment of Ulnar Neuropathy

Goldman

Brininger

Schrader

et al. 2009

Journal of Hand Therapy

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ABSTRACT:Narrative Review: As part of a comprehensive assessment for suspected ulnar neuropathy, clinical testing plays an important role in the initial identification of a lesion and determining subsequent changes from baseline. The purpose of this article was to review ulnar nerve provocative testing and the substantial collection of diagnostic signs and tests. Administration procedures for each maneuver are described as well as the resulting positive and negative outcomes. The clinical tests described constitute only one aspect of the examination and should not substitute for other key components, such as taking a thorough medical and occupational history. Empirical research studies are indicated to further quantify the relationship between the testing outcomes and the severity of a lesion as well as to determine the most robust motor signs seen in the early stages of the disease.Level of Evidence: 5. J HAND THER. 2009;22:209-20. Clinical testing is an essential component in identifying and determining the extent of pathology for many upper extremity conditions; however, it can be particularly useful for evaluating patients with ulnar neuropathy. Injury to the ulnar nerve often results in a predictable set of upper extremity sensory and motor impairments. Sensory disturbances typically involve the small and ring fingers and can also involve the dorsal-ulnar aspect of the hand if the lesion is proximal to the wrist.1 Sensory changes can contribute to motor control difficulties or even manifest as a safety issue with severe compression to afferent axons transmitting pain and temperature information. Ulnar nerve motor involvement affects most of the intrinsic hand muscles, excluding three muscles in the thenar eminence and the lumbrical muscles to the index and ring fingers. If the entrapment is at the level of the elbow, the flexor digitorum profundus (FDP) to the ring and small fingers and the flexor carpi ulnaris (the strongest wrist flexor) may become weakened.

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“…Ulnar nerve neuropathy at the elbow (UNE) is the second most common entrapment neuropathy in adults accounting for 20% of focal neuropathies demonstrated by electrophysiological studies [1]. The most common symptoms are sensory disturbances along the ulnar nerve distribution, pain at the elbow, and weakness of ulnar-innervated intrinsic hand muscles.…”

Section: Introductionmentioning

confidence: 99%

Focal Hand Dystonia in a Patient with Ulnar Nerve Neuropathy at the Elbow

Iyer

Thirkannad

2010

Hand (New York, N,Y.)

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We describe a patient who presented with dystonia of her small finger secondary to entrapment neuropathy of the ulnar nerve at the elbow. Pre operative electrophysiological studies suggested that the locus of entrapment was located proximal to the medial epicondyle. This was confirmed intraoperatively by the presence of a thickened and prominent arcade of Struthers. Surgical decompression resulted in a rapid and dramatic improvement of the dystonic pattern as well as an improvement in nerve conduction. A review of literature has not revealed any other reports of such a clear cut association between ulnar nerve entrapment and non task-specific focal hand dystonia.

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Ulnar Neuropathy at the Elbow

Cited by 58 publications

References 53 publications

Surgical Treatment for Ulnar Nerve Entrapment at the Elbow

Surgical Treatment for Ulnar Nerve Entrapment at the Elbow

A Review of Clinical Tests and Signs for the Assessment of Ulnar Neuropathy

Focal Hand Dystonia in a Patient with Ulnar Nerve Neuropathy at the Elbow

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