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Ulnar nerve

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Written by Garotta Lorenzo   

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The ulnar nerve is often compressed at the elbow while the median nerve is usually compressed at the wrist (carpal tunnel). The causes of ulnar nerve compression are varied: pain occurs in the posterior part of the elbow (especially in flexion) and the 4th and 5th finger may present some tingling . Surgical treatment is often suggested. 

 

Symptoms

The classic symptom is pain poorly localized around the posterior region of the elbow, which may worsen with elbow flexion. Sometimes a small “crack” is visible in that region for subluxation of the nerve or subluxation of the triceps. This can inflame the nerve giving rise to a classic tingling feeling in 4th and 5th fingers. Later, motor weakness is visible, associated with a claw deformity of the fingers.

 

Diagnosis 
Diagnosis of radial tunnel syndrome is based on clinical examination: three signs of neuropathy will be sought. 1) pain on palpation of the nerve in its passage through the medial epicondyle 2) elbow flexion inducing the same pain, 3) "Tinel" percussion on the nerve produces tingling or numbness of the ring and small fingers .

 

Electromyogram 
An electromyogram (EMG) is useful but sometimes difficult to interpret. Xray and CT-scans can  show osteophytes pushing up the nerve in the medial epicondyle. MRI can show nerve compression by some neoplasm (cysts...) or subluxation of the ulnar nerve.

Medical and surgical
If the diagnosis is confirmed, surgery is likely to produce good results. Surgical techniques include the release of the ulnar nerve in the elbow. Sometimes the ulnar nerve can be transposed into the subcutaneous tissue (transposition of the ulnar nerve). In these cases, to reduce recurrence of neurological pain, the release should be completed in both distal and proximal.

 

Rehabilitation and Physiotherapy

Rehabilitation of elbow surgery is crucial to get a good result and is performed according to well codified protocols. The goal is to start early rehabilitation to prevent stiffness and muscle atrophy.

(This website only provides a general guidance: it is essential that you strictly follow the advise given by the surgeon and physiotherapist who are providing the treatment.)

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Last Updated on Monday, 18 October 2010 19:49