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At least 55 records · Page 3Linked to original sources
PubMed2004

The radial nerve should be blocked before the ulnar nerve during a brachial plexus block at the humeral canal.

PURPOSE: The brachial plexus block through the humeral canal as described by Dupré is indicated in hand and forearm surgery. This block requires a multi-stimulation technique that emphasizes the necessity of a rigorous and safe technique. Nerve injury associated with regional anesthesia can entail significant morbidity for patients. Thus, we investigated the brachial block sequence in terms of unintended nerve stimulation as a surrogate of potential nerve injury. METHODS: Sixty patients were randomly allocated in two groups of 30. In Group I the radial nerve was blocked before the ulnar nerve. In Group II the ulnar nerve was blocked before the radial nerve. During the radial nerve approach we recorded, if present, an ulnar nerve response. During the ulnar nerve approach we recorded, if present, a radial nerve response. RESULTS: In Group I while looking for the radial nerve, in 50% of the cases, an ulnar motor response was recorded. In Group II while looking for the ulnar nerve, a radial motor response was recorded in 10% of the cases. CONCLUSION: Our results indicate that the radial nerve should be blocked before the ulnar nerve when performing a brachial plexus block at the humeral canal.

Adolescent↗
PubMed1997

[Anatomical study and clinical application of transfer of pronator quadratus branch of anterior interosseous nerve in the repair of thenar branch of median nerve and deep branch of ulnar nerve].

In order to obtain the anatomical basis of transferring the anterior interosseous nerve to repair the injury of thenar or ulnar nerve at the wrist level, ten fresh cadaveric forearms were dissected. The pronator quadratus branch of the median nerve was (1.5 +/- 0.4) mm in diameter with (866 +/- 144) nerve fibers. The recurrent branch of median nerve was (1.7 +/- 0.3) mm in diameter with (1,120 +/- 97) nerve fibers. The deep branch of ulnar nerve was (2.1 +/- 0.4) mm in diameter with (1,318 +/- 120) nerve fibers. To repair the thenar recurrent branch, nerve graft should be used to bridge between the distal end of the anterior interosseous nerve and the origination of the recurrent branch. The deep branch of the ulnar nerve could be repaired by direct suture after being dissected proximally. In patients, the technique was applied to repair 17 cases of injury of thenar branch and 3 cases of injury of deep branch of ulnar nerve. Among them, seventeen cases were followed up from 2 to 7 years. On electromyogram it was normal in 10. The myodynamia was restored in different degree: M2 in 2, M3 in 5, M4 in 7, M5 in 3. The procedure of the operation and the matters needed attention during the operation were discussed.

Adolescent↗
PubMedDate not supplied

[Contribution of electromyography to the study of ulnar nerve lesions in the hand. Compression syndrome of the motor branch of the ulnar nerve (author's transl)].

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.

Electromyography↗
PubMed2006

Modified intramuscular transposition of the ulnar nerve.

The ulnar nerve passes posterior to the medial epicondyle and experiences longitudinal strain when subjected to elbow flexion. Furthermore, Osborne's ligament and the arcade of fibers between the 2 heads of the flexor carpi ulnaris (Osborne's fascia) compress the nerve during elbow flexion with narrowing of the cubital tunnel passageway. Some patients experience the added element of nerve subluxation over the posterior edge of the epicondyle. When changes to daytime ergonomic behavior and sleep posture prove insufficient to relieve a patient's symptoms, surgical treatment is warranted. A range of procedures exists from simple decompression, to medial epicondylectomy, to anterior transposition. Transposition has been the most widely used method of treatment with the final position of the nerve lying subcutaneous, intramuscular, or submuscular. Each of the transposition methods has proponents with a variety of arguments made in favor of specific aspects of the surgery. This article presents a form of anterior transposition that seeks to draw the best elements from previously reported techniques with the goal of optimizing results.

Cubital Tunnel Syndrome↗
PubMed2005

Effect of body mass index on ulnar nerve conduction velocity, ulnar neuropathy at the elbow, and carpal tunnel syndrome.

Both high and low body mass index (BMI) have been reported as risk factors for ulnar neuropathy at the elbow (UNE), and a high BMI as a risk factor for carpal tunnel syndrome (CTS). To determine whether the extremes of BMI are risk factors for UNE or CTS, and whether BMI affects calculation of median and ulnar motor nerve conduction velocity (NCV), we retrospectively analyzed the electrodiagnostic records of control patients, UNE patients, and CTS patients. The BMI was calculated for 50 patients with a sole diagnosis of UNE and compared to the BMI of 50 patients with CTS and 50 control subjects. The mean BMIs were 25.9 +/- 4.4, 30.1 +/- 5.5, and 28.3 +/- 5.6 for the UNE, CTS, and controls, respectively. By one-way analysis of variance, the difference in BMI between the UNE patients and the normal patients was significant (P < 0.01). In the control groups, increasing BMI directly correlated with increasing ulnar motor NCV across the elbow but not with forearm NCV. Across-elbow (AE) ulnar motor NCV may be falsely increased in patients with a high BMI, probably due to distance measurement factors. Not only do relatively slender individuals have comparatively slower AE ulnar NCVs, they are also at increased risk for developing UNE. Patients with a high BMI are at increased risk for CTS.

Adipose Tissue↗
PubMed2006

Nerve conduction study of ulnar nerve in volleyball players.

Ulnar neuropathy at the elbow is a common disorder seen in the throwing athlete. The purpose of our study was to determine whether asymptomatic physically active volleyball players and non-actives demonstrate distinct differences in nerve conduction of the ulnar nerve at the elbow. Nerve conduction studies were performed on both arms of 24 male volleyball players and 24 male non-actives. Nerve conduction velocity at the above to below elbow segment of the ulnar motor nerve were slower in the volleyball players compared with controls and their non-dominant arms. There were no statistical differences in latencies and conduction velocity of the ulnar nerve on the forearm, both in volleyball players and in the controls. In the evoked responses of the ulnar nerve, the amplitude was the same as corresponding normal values in both sensory nerve and muscle action potentials. We conclude that abnormal ulnar (motor) nerve conduction at the elbow segment may suggest a subclinical entrapment neuropathy as a result of strenuous elbow movements in volleyball players.

Action Potentials↗
PubMed2003

Men are more susceptible than women to direct pressure on unmyelinated ulnar nerve fibers.

UNLABELLED: Ulnar nerve injury, the most common form of perioperative peripheral nerve injury, has a 3:1 male/female predominance. Neither the mechanism of perioperative ulnar nerve injury nor the reasons for the increased male susceptibility are well understood. We used an experimental model with arm flexion at the elbow, direct pressure on the ulnar nerve, and arm ischemia as distinct stress mechanisms to induce adverse changes in ulnar current perception thresholds (CPTs) on 3 groups of 40 male and 40 female volunteers (a total of 240 volunteers). CPT measurements were repeated at 2000-, 250-, and 5-Hz stimulating frequencies, specific to A-beta, A-delta, and unmyelinated C-fibers, respectively. Ischemia produced significant increases in CPT with all three stimulating frequencies, and there were no detectable differences between men and women. Flexion failed to produce significant CPT increases at any of the three stimulating frequencies, with no sex-based differences. Direct pressure produced significant CPT increases at 5 and 250 Hz, indicating inhibition of both unmyelinated C-fibers and myelinated A-delta fibers. C-fibers, but not A-delta fibers, demonstrated sex differences with direct pressure; there was a 1.7-fold (95% confidence interval, 1.2- to 2.4-fold) greater effect in men. Ischemia significantly inhibited the function of all three fiber types, perhaps sufficient to overwhelm gender differences. IMPLICATIONS: The ability of direct pressure to produce a greater inhibition of unmyelinated C-fibers in male subjects compared with female subjects is consistent with, and may help explain, the male increased susceptibility to perioperative ulnar nerve dysfunction.

Adult↗
PubMed1993

Group fascicular vein grafts with interposition of nerve slices for long ulnar nerve defects: report of three cases.

Group fascicular vein grafts with interposition of nerve slices were designed for reconstruction of three ulnar nerves with defects of 2.5-4.5 cm. The veins were taken from superficial veins in the forearm and reversed to bridge the fascicles in both stumps. Normal nerve slices were sectioned from fascicles in the proximal stump and inserted inside the corresponding vein conduits. Postoperatively, the Tinel's sign was detected across the vein conduits, and electromyography showed reinnervation of intrinsic muscles of the hands. Follow-up for more than 2 years revealed motor recovery to M4 and sensory recovery to S3-S4 in these three cases. This technique may be a promising alternative to group fascicular nerve grafting for long defects in peripheral nerve trunks.

Adult↗
PubMed1989

[Evaluation of conductivity in motor nerve fibers of the ulnar nerve in syringomyelia and neuropathy using 6 stimulation indicators].

The ulnar nerve's motoric fibre conduction velocity was stated to be insignificantly disordered in 32 patients with syringomyelia, whereas 47 neuropathic patients with unknown etiology showed the disorder mentioned above as occurring by far more frequently and in a more extent. From 6 stimulative indices, those of distal extremities velocity had maximum of deviations. Nevertheless, the indices of longer sections revealed the most numerous pathologic findings, especially in determining forearm velocity. The obtained findings are compared with 233 control subjects.

Adult↗
PubMed1996

The effect of the high palmar nerve block and the ulnar nerve block on lameness provoked by a collagenase-induced tendonitis of the lateral branch of the suspensory ligament.

Controversy exists with respect to the innervation of the suspensory ligament (SL) in the fore limb of the horse. It is uncertain whether this structure is exclusively innervated by branches of the ulnar nerve or also to some extent by median nerve branches. Ground Reaction Forces (GRF) were determined in horses before and after the induction of a tendonitis in the lateral branch of the SL by the injection of collagenase, and before and after a high palmar and an ulnar block respectively. The high palmar block succeeded in bringing all GRF variables back to their original values which the ulnar block did not. It is concluded that the SL is innervated by branches of both the ulnar and the median nerves, with the median nerve being relatively more important for the distal part of the SL.

Animals↗
PubMed2000

Nerve sheath ganglion of the ulnar nerve.

We report a case of a nerve sheath ganglion of the ulnar nerve at the canal of Guyon. This case involved a ganglion which was confined to the epineurium of the ulnar nerve. and it was completely excised without any damage to the nerve fiber. A nerve-sheath ganglion is rare, but it should be considered in the differential diagnosis of any tumor which is causing neural disturbance.

Adult↗
PubMed1978

Combined posterior interosseous and ulnar nerve compression in a hemophiliac.

A case is reported of a combined posterior interosseous nerve and ulnar nerve decompression in a patient with hemophilia after appropriate blood factor replacement. The importance of avoiding unnecessary delay in surgical intervention and careful attention to details of operative and postoperative care are stressed.

Adult↗
PubMed1998

Anatomic considerations in evaluation of the proximal ulnar nerve.

Knowledge of general ulnar anatomy aids in the understanding of the possible site of ulnar nerve entrapment and the rationale for differential diagnosis possibilities. Understanding of internal nerve topography sheds light on reasons for ulnar nerve susceptibility at the elbow region and offers an explanation for the sparing of forearm muscles in ulnar neuropathy at the elbow. Dynamic anatomy or biomechanics of the elbow help elucidate the pathophysiology of ulnar nerve compression at the elbow. The anatomy interface with electrodiagnosis illustrates rationale for particular methods employed and particular tests used in evaluating the ulnar nerve. Electrodiagnostic testing enhances localization of ulnar nerve lesions, excludes other causes in the differential diagnosis, and may aid with surgical selection.

Biomechanical Phenomena↗
PubMed1987

Bilateral anomalous course of the ulnar nerve at the wrist causing ulnar and median nerve compression syndrome. Case report.

The case of a patient with a bilateral compression syndrome of the ulnar and median nerves at the wrist is described. Both ulnar nerves, which were surgically explored at different times, followed an anomalous course and passed into the canalis carpi side by side with the median nerve. This variation in the course of the ulnar nerve is extremely rare and causes a unique syndrome with characteristic electromyographic patterns.

Adult↗