olenia2Characterised by the ulnar nerve pressure at the level of the elbow. It is the second most common compression neuropathy syndrome after carpal tunnel syndrome.

The ulnar nerve is one of the major nerves of the hand, providing the sensation in the little finger and half the ring finger.

But the most important feature is the small muscles of the hand. These small muscles control fine movements of the hand and fingers.

Ulnar neuritis is caused by compression of the ulnar nerve on the physical tunnel that is behind the medial condyle of humerus. Usually pressure coexists with traction in the nerve.

The most common causes are overuse (repetitive flexion-extension movements of the elbow) and the immediate pressure over the elbow for long periods.

Other problems may be implicated in ulnar neuritis as elbow injuries (fractures or ligamentous damage), local tumours (ganglions) or exostoses.

Symptoms may vary, but usually includeolenia3

  • numbness along the forearm, of the little finger and half of the ring finger,
  • reduction of the grip force (fist), difficulty in opening jars or turning doorknobs,
  • sense of "clumsy" hand operation
  • causalgia (burning pain sensation) at the elbow and hand

 


A percentage of cases respond positively to conservative treatment .This treatment involves modification of daily activities to avoid consecutive - repeated flexion of the elbow and avoid applying direct pressure to the area.

Surgery can be done in the daily treatment department or one day stay in hospital, under general or regional anaesthesia.

There are two basic methods

Decompression of the ulnar nerve by simple release of the cubital canal

Forward transfer of the ulnar nerve either subcutaneously or below the common tendon of the flexor muscles.

In our clinic, the method of choice is the transfer of the nerve below the common flexor tendon, with excellent results.

After surgery the upper limb is immobilised in a long splint for 2 weeks. After removing the splint, a physiotherapy program is required that includes stretching exercises to restore the full range of flexion - extension of the elbow.

The physiotherapy program will gradually be intensified until fully restore motion and strength.

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* Patient consent was obtained for publication of figures