Compression neuropathies

2021 ◽  
pp. 294-302
Author(s):  
Lars B. Dahlin ◽  
Niels Thomsen
Keyword(s):  
Magnetic Resonance Imaging ◽  
Risk Factors ◽  
Primary Treatment ◽  
Nerve Trunk ◽  
Motor Dysfunction ◽  
Nerve Compression ◽  
Ulnar Nerve Compression ◽  
Careful Clinical Examination ◽  
Tunnel Syndrome ◽  
Simple Decompression

Nerve compression disorders affect nerve trunks, particularly in the upper extremity where carpal tunnel syndrome (median nerve compression at the wrist) is the most common and ulnar nerve compression the second most common disorder. Compression affects the various components of the nerve trunk, including the intraneural blood vessels, the Schwann cells, the axons, and the connective tissue components. It results in sensory and motor dysfunction, and sometimes pain. Risk factors for nerve compression disorders are known and may predict surgical outcome. A careful clinical examination should always be done, sometimes complemented with appropriate electrophysiology and magnetic resonance imaging for diagnosis. If conservative treatment is not appropriate, or fails, simple decompression is generally the primary treatment, but problems may persist. The presence of other neuropathies should be considered.

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.

Severe ulnar nerve entrapment at the elbow: functional outcome after minimally invasive in situ decompression

2012 ◽  
Vol 37 (2) ◽  
pp. 115-122 ◽  
Author(s):  
K. Karthik ◽  
R. Nanda ◽  
S. Storey ◽  
J. Stothard
Keyword(s):  
Minimally Invasive ◽  
Grip Strength ◽  
Ulnar Nerve ◽  
Nerve Compression ◽  
Ulnar Nerve Compression ◽  
Pinch Grip ◽  
Simple Decompression

The role of in situ decompression in patients with severe ulnar nerve compression is still controversial. Thirty patients with severe ulnar nerve compression confirmed clinically and electrophysiologically underwent simple decompression. The mean age of the patients was 58 (range 26–87) years. Through incisions ≤4 cm the nerves were fully visualized and decompressed. Outcome was measured prospectively using Modified Bishop’s score (BS), grip and pinch strengths and two-point discrimination (2PD). Significant improvement in power (p = 0.01) and pinch grip (p = 0.001) was noted at 1 year. The grip strength continued to improve up to 1 year. According to the BS, 24 patients (80%) had good to excellent results at 1 year. Minimally invasive in situ decompression is technically simple, safe and gives good results in patients with severe nerve compression. The BS and 2PD were more reliable than grip strength in assessing these patients at follow-up.

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.

RISK FACTORS FOR DISLOCATION OF THE ULNAR NERVE AFTER SIMPLE DECOMPRESSION FOR CUBITAL TUNNEL SYNDROME

Hand Surgery ◽  
2014 ◽  
Vol 19 (01) ◽  
pp. 13-18 ◽  
Author(s):  
K. Murata ◽  
S. Omokawa ◽  
T. Shimizu ◽  
Y. Nakanishi ◽  
K. Kawamura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ulnar Nerve ◽  
High Probability ◽  
Multiple Logistic Regression Analysis ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Anterior Dislocation ◽  
Multiple Logistic Regression ◽  
Tunnel Syndrome ◽  
Simple Decompression

Anterior dislocation of the ulnar nerve is occasionally encountered after simple decompression of the nerve for treatment of cubital tunnel syndrome. The purpose of this study was to determine whether the incidence of dislocation of the nerve following simple decompression of the nerve is correlated with the patient's preoperative characteristics and/or elbow morphology. We studied 51 patients with cubital tunnel syndrome who underwent surgery at our institution. Intraoperatively, we simulated dislocation of the nerve after simple decompression by flexing the elbow after releasing the nerve in each patient. Univariate and multiple logistic regression analysis showed that young age and a small ulnar nerve groove angle are positively correlated with dislocation of the nerve. Our results suggest that patients who are young and/or have a sharply angled ulnar nerve groove identified radiographically have a high probability of experiencing anterior dislocation of the ulnar nerve after simple decompression.

Ulnar Nerve Entrapment Neuropathy at the Elbow: Simple Decompression

Neurosurgery ◽  
2004 ◽  
Vol 55 (5) ◽  
pp. 1150-1153 ◽  
Author(s):  
Jason H. Huang ◽  
Uzma Samadani ◽  
Eric L. Zager
Keyword(s):  
Ulnar Nerve ◽  
Surgical Techniques ◽  
Cubital Tunnel Syndrome ◽  
Nerve Entrapment ◽  
Entrapment Neuropathy ◽  
Ulnar Nerve Entrapment ◽  
Careful Clinical Examination ◽  
Electrophysiological Studies ◽  
Tunnel Syndrome ◽  
Simple Decompression

Abstract ULNAR NERVE ENTRAPMENT neuropathy at the elbow, or the cubital tunnel syndrome, is frequently encountered in neurosurgical practice as the second most common peripheral nerve entrapment after carpal tunnel syndrome. Patients typically present with weakness or atrophy of the hand as well as paresthesias in the ulnar nerve distribution. The diagnosis can be confirmed with a careful clinical examination and electrophysiological studies. Patients who have failed conservative therapy are considered for surgery. Although a number of surgical options are available, simple decompression of the ulnar nerve can achieve satisfactory results with appropriate patient selection. We describe the relevant anatomy and surgical techniques for simple in situ decompression of the ulnar nerve at the elbow.

scholarly journals The Association Between Concomitant Ulnar Nerve Compression at the Elbow and Carpal Tunnel Syndrome

Hand ◽  
2018 ◽  
Vol 15 (3) ◽  
pp. 335-340 ◽  
Author(s):  
Brandon Shulman ◽  
Jonathan Bekisz ◽  
Christopher Lopez ◽  
Samantha Maliha ◽  
Siddharth Mahure ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Nerve Compression ◽  
Concomitant Treatment ◽  
Ulnar Nerve Compression ◽  
Median Nerve Compression ◽  
Number Of Patients ◽  
Tunnel Syndrome

Background: Many patients treated for ulnar nerve compression at the elbow (UNE) are concomitantly treated for carpal tunnel syndrome (CTS). We sought to investigate the association between the conditions. Methods: The Statewide Planning and Research Cooperative System (SPARCS) database was used to determine the number of patients with UNE concomitantly treated for CTS in New York State from 2003 to 2014. We then retrospectively reviewed each patient who received surgical treatment for UNE (n = 222 patients) or CTS (n = 1063 patients) at our tertiary care institution in 2014 and 2015 to assess concomitant treatment. Results: In the SPARCS database, the percentage of patients surgically treated for concomitant UNE and CTS steadily increased from 23% in 2003 to 45% in 2014. At our institution, 50 of 222 patients (23%) surgically treated for UNE underwent concomitant carpal tunnel releases. For concomitantly treated patients, 94% had examinations consistent with UNE and CTS, 87% of patients had median nerve compression on electrodiagnostic tests, and 72% of patients had UNE on electrodiagnostic tests. Conclusions: Most patients concomitantly treated for UNE and CTS have objective findings of both conditions. At least one-fourth of patients indicated for operative ulnar nerve release also require a carpal tunnel release—far beyond the prevalence of CTS in the general population. A diagnosis of UNE merits a comprehensive workup by the treating surgeon and a high suspicion for concomitant median nerve compression.

scholarly journals Patient Characteristics in Ulnar Nerve Compression at the Elbow at a Tertiary Referral Hospital and Predictive Factors for Outcomes of Simple Decompression versus Subcutaneous Transposition of the Ulnar Nerve

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Alice Giöstad ◽  
Erika Nyman
Keyword(s):  
Ulnar Nerve ◽  
Patient Characteristics ◽  
Referral Hospital ◽  
Nerve Compression ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Ulnar Nerve Compression ◽  
Increased Risk ◽  
Subcutaneous Transposition ◽  
Simple Decompression

Patient characteristics and predictive factors for outcomes were analysed in 202 cases undergoing simple decompression, primary subcutaneous transposition, or secondary subcutaneous transposition for ulnar nerve compression at the elbow at a tertiary referral hospital. Data from medical charts and a survey were evaluated. The mean patient age was 49 years with revision surgery cases being significantly younger. Sixty-one percent of cases were female, and 31% were smokers. The comorbidity was extensive, including other nerve compression lesions as well as neck and shoulder problems. Overall, 53% reported being pleased with the result of surgery and 57% of the cases rated function as better or completely recovered after surgery. The median postoperative DASH (Disabilities of the Arm, Shoulder and Hand) score was 26 (IQR 11–49), which is in accordance with unpublished national data. No significant differences in DASH scores were found between surgical groups, but a higher preoperative McGowan grade was significantly associated with a poorer postoperative DASH score. Women scored greater disability postoperatively than men. There was a significantly increased risk of complications, which was doubled for smokers, following primary and secondary transposition compared to simple decompression. Surgical cases with ulnar nerve compression treated at a tertiary referral hospital constitute a heterogeneous group with great comorbidity and frequent concomitant nerve compression lesions. We suggest simple decompression as the procedure of first choice. Transposition can be used in selected cases or when simple decompression fails. All patients should be strongly recommended to stop smoking considering the remarkably increased risk for complications among smokers.

Ganglion-Associated Ulnar Tunnel Syndrome Treated by Ultrasonographically Assisted aspiration and Splinting

2003 ◽  
Vol 28 (2) ◽  
pp. 177-178 ◽  
Author(s):  
K. NAKAMICHI ◽  
S. TACHIBANA
Keyword(s):  
Ulnar Nerve ◽  
Nerve Palsy ◽  
Nerve Compression ◽  
Ultrasonographic Examination ◽  
Ulnar Nerve Compression ◽  
Ulnar Nerve Palsy ◽  
Tunnel Syndrome ◽  
Ulnar Tunnel

We describe a case of ulnar nerve compression at the wrist due to a ganglion. This was treated by aspiration of the ganglion under ultrasonography and splinting because the patient was pregnant. The ulnar nerve palsy resolved completely and the ganglion disappeared. A follow-up ultrasonographic examination after 2 years showed no recurrence of the ganglion.

Surgical Approach to Ulnar Nerve Compression at the Elbow Caused by the Epitrochleoanconeus Muscle and a Prominent Medial Head of the Triceps

2008 ◽  
Vol 62 (suppl_1) ◽  
pp. ONS186-ONS193 ◽  
Author(s):  
Olga Gervasio ◽  
Claudio Zaccone
Keyword(s):  
Ulnar Nerve ◽  
Surgical Approach ◽  
Complete Recovery ◽  
Cubital Tunnel Syndrome ◽  
Surgical Anatomy ◽  
Nerve Compression ◽  
Ulnar Nerve Compression ◽  
Medial Head ◽  
Surgical Options ◽  
Simple Decompression

Abstract Objective: We sought to describe the operative technique in ulnar nerve compression caused by the epitrochleoanconeus muscle and a prominent medial head of the triceps. These anatomic features make the approach to the ulnar nerve at the elbow peculiar and may create technical difficulties during surgical treatment of this area. Methods: We reviewed patients who underwent surgery for cubital tunnel syndrome between November 1997 and December 2004. The presence of the epitrochleoanconeus muscle with prominent medial head of the triceps occurred in 3.2% of patients. A detailed and illustrated description of the surgical anatomy and the peculiarities of the surgical approach are provided. Results: Epitrochleoanconeus muscle and the prominent portion of the medial head of the triceps were sectioned and removed, and simple decompression of the ulnar nerve was performed. This treatment achieved complete recovery in all of the patients affected by moderate-grade syndrome (Dellon Grade 2 syndrome) who had not shown severe-grade syndrome preoperatively. Conclusion: The simple decompression of the ulnar nerve with myotomy or removal of epitrochleoanconeus muscle and the prominent portion of the medial head of the triceps achieved good postoperative results. Experiences from the literature and alternative surgical options are reported.

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