SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
A rare case of neurilemmoma of the deep branch of the ulnar nerve presented as ulnar nerve compression syndrome. This tumour was arising from the deep branch at the wrist just distal to the ulnar tunnel. By its proximity to the sensory division, it led to sensory symptoms in the ulnar two digits. Certain features of this case, which are uncommon are discussed.
Ulnar tunnel syndrome or compression of the ulnar nerve at the wrist is of two distinct types. In the first type compression is at the level of the pisiform with involvement of both sensory and motor fibres. In the second type compression is distal to the pisiform with involvement of the motor fibres only.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
During clinical and electromyographical examination of one patient with diabetic and one with alcoholic polyneuropathy we found an especially severe lesion of the ulnar nerve at the elbow on one side. As the polyneuropathy generally affects the nerves symmetrically we presumed in addition some other most probably ulnar nerve compression syndrome at the elbow. Both patients were operated and the nerves were transposed (Prof. NIGST). The local finding during the operation, the improvement of the paresis of ulnar nerve and the worsening of the polyneuropathy--found simultaneously at control after 2 and 4 years--confirmed our supposition. Should in cases of polyneuropathy an especially severely damaged nerve be found, one ought to think of the possibility of an additional mechanical lesion and treat the patient accordingly.
Ulnar nerve compression at the elbow is commonly accepted as the second most frequent compressive peripheral neuropathy. The unique anatomic location of the ulnar nerve directly posterior to the medial epicondyle at the elbow places it at risk for injury. With normal motion of the elbow, the ulnar nerve is subjected to compression, traction, and frictional forces. Compression can occur at any of the 5 sites that begin proximally at the arcade of Struthers and end distally where the nerve exits the flexor carpi ulnaris in the forearm. Initial treatment of compressive neuropathy is nonoperative, usually consisting of rest, modification, and/or restriction of elbow or wrist movement. If symptoms persist, especially when accompanied by muscle weakness, surgery is usually indicated. Surgical options include decompression in situ, medial epicondylectomy, transposition of the ulnar nerve (subcutaneous, intramuscular, or submuscular), and/or a combination of these procedures. Careful decompression with a subtotal medial epicondylectomy is a valuable procedure that allows decompression at all levels with minimal risk of devascularizing the nerve or creating elbow instability.
BACKGROUND: The formation of heterotopic ossification (HO) about the elbow after traumatic injury has been well documented in the literature. The optimal treatment, however, for ectopic bone associated with restricted range of motion and ulnar nerve entrapment syndrome has not been established. METHODS: Seven elbows with HO in 7 patients admitted to Chang Gung Memorial Hospital from April 1998 to January 1999 presented with limited range of motion and associated ulnar nerve neuropathy. All of these patients received early surgical excision of HO combined with release of the encased ulnar nerve and anterior transposition, followed by early gentle passive physical therapy and active exercise within the pain-free range of motion postoperatively. RESULTS: Almost full range of motion and complete functional ability following surgery were recovered in 6 of the 7 patients, while I patient who suffered from multiple traumatic injuries had limited improvement from 45 degrees ankylosis to 10 degrees approximately 90 degrees of a flexion-extension motion arc. CONCLUSION: Our results suggest that early surgical management combined with gentle physical therapy postoperatively is a feasible modality for treating patients with post-traumatic HO about the elbow presenting as limited range of motion and associated ulnar nerve compression syndrome.
Compression of the median and ulnar nerves at the wrist is frequently encountered. Carpal tunnel syndrome usually occurs without any obvious extrinsic cause; several cases have however been reported caused by anomalous or hypertrophic muscles. A survey of the literature shows that compression neuropathy of the median nerve has been reported in relation with anomalies affecting three muscles: the first (or second) lumbrical, the palmaris longus and its anatomic variants and the superficial flexor of the index finger. In the ulnar tunnel the situation is thoroughly different: so-called idiopathic ulnar tunnel syndrome is rare and an extrinsic compressing structure can usually be disclosed. Anomalous muscles belong to the palmaris longus/abductor digiti minimi group; the flexor carpi ulnaris is sometimes involved. One can suspect the presence of such an anomalous muscle when the compression syndrome concerns a patient who is not within the "usual" age group with symptoms initiated or aggravated by physical exercise.
Compression-induced damage to the peripheral nerves can cause persistent, mostly exercise-related intensified pain syndromes. In the presence of brachialgia, compression neuropathies must always be considered when rendering the differential diagnosis, whether in the scapular region (e.g. suprascapular syndrome) in the elbow (e.g. supinator syndrome) or the hand (carpal tunnel syndrome, distal ulnar tunnel syndrome). Knowledge of neuroanatomy, detailed history of pain and provocative movements and a targeted examination technique including the findings of provocative testing will usually lead to an accurate diagnosis. Focal neural damage, its exact localization and degree of severity can all be confirmed by the targeted use of electroneurography and needle myography. These procedures will also allow a prognostic estimation and provide information about whether surgical therapeutic procedures are indicated.
General techniques of electrodiagnostic examination, how such examination can predict the pathophysiology of nerve injury, and specific techniques and findings of the major entrapments such as carpal tunnel syndrome and ulnar nerve neuropathy are described in detail. Additional disease states that relate to hand surgery, such as anterior interosseous syndrome, brachial plexopathy, radiculopathy, polyneuropathy, and the nebulous entity of thoracic outlet syndrome are discussed.
Standard electromyographic investigations: detection and stimulodetection; segmental motor nerve conduction rate, distal motor latencies (interphalangeal V and I short abductor muscles), and distal sensory (antidromic) conduction time, were used to explore seven cases of distal paralysis of the ulnar nerve. Results enabled differentiation of elective lesions of the deep motor branch from those of the ulnar nerve in Guyon's canal. These two types of lesion correspond to precise anatomical features: the channel between the pisiform and unciform bones on the one hand and Guyon's canal on the other. The electroclinical syndrome of the deep branch should be considered as a separate true canalicular syndrome. Treatment is by surgery in most cases.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
OBJECTIVE: To review the anatomy, etiology, and symptoms associated with compressive ulnar neuropathy at the elbow and to discuss the diagnosis and treatment of this condition. DATA SOURCE: The following were searched for information relevant to cubital tunnel syndrome: MEDLINE, WorldCat, and Index to Chiropractic Literature. RESULTS: Cubital tunnel syndrome is the second most common nerve compression syndrome of the upper extremity. Clinical features of this syndrome are described along with electrodiagnostic techniques that can be used to provide evidence concerning the probable location, character, and severity of the lesion affecting the ulnar nerve. Conservative treatment of cubital tunnel syndrome is recommended for patients with intermittent symptoms and without changes in cutaneous sensation or muscle atrophy. CONCLUSION: A definitive diagnosis can best be made using clinical tests along with nerve conduction studies and electromyography, conservative treatment can be effective in treating this neuropathy in mild cases; in moderate or severe cases, surgery may be necessary.
Explore the source record for details and available documents.
Explore the source record for details and available documents.