The Ulnar Nerve at the Elbow and its Local Branching: An Anatomic Study

2001 ◽  
Vol 26 (2) ◽  
pp. 142-144 ◽  
Author(s):  
M. H. GONZALEZ ◽  
P. LOTFI ◽  
A. BENDRE ◽  
Y. MANDELBROYT ◽  
N. LIESKA
Keyword(s):  
Ulnar Nerve ◽  
Significant Variation ◽  
Medial Epicondyle ◽  
Nerve Compression ◽  
Cubital Tunnel ◽  
Anatomic Study ◽  
Local Branching ◽  
Flexor Carpi Ulnaris

Thirty nine cadaver elbows were dissected and the branching of the ulnar nerve, as well as the cubital tunnel and adjacent potential sites of nerve compression were studied. An arcade of Struthers was present in 26 specimens and Osborne’s ligament was present in all specimens. A discrete flexor pronator aponeurosis overlying the ulnar nerve was present in 17 specimens. An average of one (range, 0–3) capsular nerve branches were noted. These originated an average 7 mm proximal (range, 45 mm proximal to 24 mm distal) to the medial epicondyle. An average of three (range, 1–6) motor branches to the flexor carpi ulnaris muscle were noted, and one of these originated proximal to the medial epicondyle in two specimens. Significant variation was noted in the capsular and motor branching of the ulnar nerve. Care must be taken to identify the motor branches of the ulnar nerve when performing a transposition.

Surgery of ulnar neuropathy at the elbow: 16 cases treated by decompression without transposition

1973 ◽  
Vol 38 (6) ◽  
pp. 780-785 ◽  
Author(s):  
Donald H. Wilson ◽  
Robert Krout
Keyword(s):  
Ulnar Nerve ◽  
Nerve Palsy ◽  
Medial Epicondyle ◽  
Ulnar Neuropathy ◽  
Cubital Tunnel ◽  
Content Type ◽  
Anterior Transposition ◽  
Ulnar Nerve Palsy ◽  
Flexor Carpi Ulnaris ◽  
Fine Print

✓ The authors report 16 consecutive cases of ulnar nerve palsy at the elbow successfully relieved by simple division of the tendinous insertions of the flexor carpi ulnaris, which form the roof of the “cubital tunnel.” They believe the more complex procedures of anterior transposition of the nerve or resection of the medial epicondyle are unnecessary, and even undesirable.

A CASE REPORT OF ACUTE CUBITAL TUNNEL SYNDROME CAUSED BY VENOUS THROMBOSIS

Hand Surgery ◽  
2015 ◽  
Vol 20 (01) ◽  
pp. 137-139 ◽  
Author(s):  
Yoshihiro Abe ◽  
Masahiko Saito
Keyword(s):  
Case Report ◽  
Venous Thrombosis ◽  
Ulnar Nerve ◽  
Cubital Tunnel Syndrome ◽  
Nerve Compression ◽  
Ulnar Neuropathy ◽  
Cubital Tunnel ◽  
Ulnar Nerve Compression ◽  
Compression Neuropathy ◽  
Tunnel Syndrome

Compression neuropathy of the ulnar nerve at the elbow is well-recognised as cubital tunnel syndrome (CuTS). Many causes of ulnar neuropathy at the elbow have been identified. A previously unreported finding of ulnar nerve compression in the cubital tunnel caused by a thrombosed proximal ulnar recurrent artery vena comitans is described.

scholarly journals Ulnar Nerve Enlargement at the Medial Epicondyle Negatively Correlates With Nerve Conduction Velocity in Cubital Tunnel Syndrome

Hand ◽  
2018 ◽  
Vol 15 (2) ◽  
pp. 165-169
Author(s):  
T. David Luo ◽  
Amy P. Trammell ◽  
Luke P. Hedrick ◽  
Ethan R. Wiesler ◽  
Francis O. Walker ◽  
...  
Keyword(s):  
Ulnar Nerve ◽  
Nerve Conduction ◽  
Nerve Conduction Velocity ◽  
Motor Nerve ◽  
Cubital Tunnel Syndrome ◽  
Medial Epicondyle ◽  
Cubital Tunnel ◽  
Motor Nerve Conduction ◽  
Nerve Enlargement ◽  
Tunnel Syndrome

Background: In cubital tunnel syndrome (CuTS), chronic compression often occurs at the origin of the flexor carpi ulnaris at the medial epicondyle. Motor nerve conduction velocity (NCV) across the elbow is assessed preoperatively to corroborate the clinical impression of CuTS. The purpose of this study was to correlate preoperative NCV to the direct measurements of ulnar nerve size about the elbow at the time of surgery in patients with clinical and/or electrodiagnostic evidence of CuTS. Methods: Data from 51 consecutive patients who underwent cubital tunnel release over a 2-year period were reviewed. Intraoperative measurements of the decompressed nerve were taken at 3 locations: at 4 cm proximal to the medial epicondyle, at the medial epicondyle, and at the distal aspect of Osborne fascia at the flexor aponeurotic origin. Correlation analysis was performed comparing nerve size measurements to slowing of ulnar motor nerve conduction velocities (NCV) below the normal threshold of 49 m/s across the elbow. Results: Enlargement of the ulnar nerve at the medial epicondyle and nerve compression at the flexor aponeurotic origin was a consistent finding. The mean calculated cross-sectional area of the ulnar nerve was 0.21 cm2 above the medial epicondyle, 0.30 cm2 at the medial epicondyle, and 0.20 cm2 at the flexor aponeurotic origin ( P < .001). There was an inverse correlation between change in nerve diameter and NCV slowing ( r = −0.529, P < .001). Conclusions: For patients with significantly reduced preoperative NCV and clinical findings of advanced ulnar neuropathy, surgeons can expect nerve enlargement, all of which may affect their surgical decision-making.

The effect of in-situ decompression on ulnar nerve stability: a cadaveric study

2017 ◽  
Vol 42 (7) ◽  
pp. 715-719 ◽  
Author(s):  
B. Butler ◽  
J. Peelman ◽  
L.-Q. Zhang ◽  
M. Kwasny ◽  
D. Nagle
Keyword(s):  
Ulnar Nerve ◽  
Medial Epicondyle ◽  
Cadaveric Study ◽  
Flexion Angle ◽  
Anterior Translation ◽  
Nerve Decompression ◽  
Flexor Carpi Ulnaris ◽  
Before And After ◽  
Fresh Frozen

Ten fresh frozen right cadaver arms were placed in a motorized jig and an in-situ ulnar nerve decompression was performed in 5 mm increments distally to the flexor carpi ulnaris (FCU) aponeurosis then proximally to the intermuscular septum. The elbows were ranged 0–135° after each incremental decompression and the ulnar nerve to medial epicodyle distance was measured to assess for nerve translation/subluxation compared with baseline (prerelease) values. None of the specimens had ulnar nerve subluxation (defined as anterior translation past the medial epicondyle) even after full decompression. Furthermore, there were no statistically significant ulnar nerve translations (defined as any difference in distance from ulnar nerve to medial epicondyle before and after each decompression) for any flexion angle or extent of decompression. This study provides biomechanical evidence that in situ ulnar nerve decompression from the FCU aponeurosis to the intermuscular septum does not result in significant ulnar nerve translation or subluxation.

Acute Cubital Tunnel Syndrome from Post Traumatic Calcific Neuritis

1986 ◽  
Vol 11 (1) ◽  
pp. 123-124
Author(s):  
K. AMETEWEE
Keyword(s):  
Ulnar Nerve ◽  
Unusual Case ◽  
Cubital Tunnel Syndrome ◽  
Nerve Compression ◽  
Cubital Tunnel ◽  
Complete Regression ◽  
Minor Trauma ◽  
Ulnar Nerve Compression ◽  
Tunnel Syndrome ◽  
Post Traumatic

The normal ulnar nerve is not visible on radiographs of the elbow. An unusual case is described in which symptoms of ulnar nerve compression with a swollen, tender ulnar nerve at the elbow developed after relatively minor trauma. Radiology suggested “Calcific Neuritis”, but this was short lived with complete regression of the symptoms.

Morphology of the Cubital Tunnel: An Anatomical and Biomechanical Study With Implications for Treatment of Ulnar Nerve Compression

2011 ◽  
Vol 36 (12) ◽  
pp. 1988-1995 ◽  
Author(s):  
Jaison James ◽  
Levi G. Sutton ◽  
Frederick W. Werner ◽  
Niladri Basu ◽  
Mari A. Allison ◽  
...  
Keyword(s):  
Ulnar Nerve ◽  
Biomechanical Study ◽  
Nerve Compression ◽  
Cubital Tunnel ◽  
Ulnar Nerve Compression

scholarly journals The 7 Structures Distal to the Elbow That Are Critical to Successful Anterior Transposition of the Ulnar Nerve

Hand ◽  
2018 ◽  
Vol 14 (6) ◽  
pp. 776-781 ◽  
Author(s):  
John M. Felder ◽  
Susan E. Mackinnon ◽  
Megan M. Patterson
Keyword(s):  
Ulnar Nerve ◽  
Ulnar Artery ◽  
Cubital Tunnel Syndrome ◽  
Medial Epicondyle ◽  
Cubital Tunnel ◽  
Anterior Transposition ◽  
Straight Line ◽  
Tunnel Syndrome ◽  
Poor Outcomes ◽  
Flexor Digitorum

Background: Ulnar nerve transposition (UNT) surgery is performed for the treatment of cubital tunnel syndrome. Improperly performed UNT can create iatrogenic pain and neuropathy. The aim of this study is to identify anatomical structures distal to the medial epicondyle that should be recognized by all surgeons performing UNT to prevent postoperative neuropathy. Methods: Ten cadaveric specimens were dissected with attention to the ulnar nerve. Intramuscular UNT surgery was simulated in each. Distal to the medial epicondyle, any anatomical structure prohibiting transposition of the ulnar nerve to a straight-line course across the flexor-pronator mass was noted and its distance from the medial epicondyle was measured. Results: Seven structures were found distal to the medial epicondyle whose recognition is critical to ensuring a successful anterior transposition of the ulnar nerve: (1) Branches of the medial antebrachial cutaneous (MABC) nerve; (2) Osborne’s fascia; (3) branches from the ulnar nerve to the flexor carpi ulnaris (FCU); (4) crossing vascular branches from the ulnar artery to the FCU; (5) the distal medial intermuscular septum between the FCU and flexor digitorum superficialis (FDS); (6) the combined muscular origins of the flexor-pronator muscles; and (7) the investing fascia of the FDS. Measurements are given for each structure. Conclusions: Poor outcomes and unnecessary revision surgeries for cubital tunnel syndrome can be avoided with intraoperative attention to 7 structures distal to the medial epicondyle. Surgeons should expect to dissect up to 12 cm distal to the medial epicondyle to adequately address these and prevent kinking of the nerve in transposition.

Anomalous Muscles and Ulnar Nerve Compression at the Wrist

HAND ◽  
1977 ◽  
Vol os-9 (2) ◽  
pp. 140-142 ◽  
Author(s):  
M. S. Turner ◽  
D. M. Caird
Keyword(s):  
Ulnar Nerve ◽  
The Other ◽  
Nerve Compression ◽  
Ulnar Nerve Compression ◽  
Palmaris Longus ◽  
Flexor Carpi Ulnaris

A Report of two cases of anomalous muscles causing ulnar nerve compression. One appeared to be related to the flexor carpi ulnaris and the other to the more usual palmaris longus.

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