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At least 19 recordsLinked to original sources
PubMed1977

Ulnar nerve instability: ulnar nerve injury due to elbow flexion.

The term "ulnar nerve instability" describes the chronic conditions of subluxation and relocation of the ulnar nerve at the elbow with flexion and extension of the elbow, respectively. This condition is more common than generally thought. Recurrent subluxation of the nerve at the elbow results in a tractional and frictional neuritis. The nerve is vulnerable to trauma in its subluxed position, lying superficially on the medial humeral epicondyle. In certain cases of ulnar nerve instability associated with a tight overlying band bridging the heads of origin of the flexor carpi ulnaris, nerve injury can occur with flexion of the elbow. Thus, internal as well as external compressive factors as a cause of ulnar nerve neuropathy must be considered. Described is an elbow flexion test helpful in the diagnosis and prognosis of cases of ulnar nerve instability associated with the tight overlying band.

Adolescent↗
PubMed1997

[Is transposition of the ulnar nerve in ulnar nerve sulcus syndrome really indicated?].

Anterior transposition of the ulnar nerve in cubital tunnel syndrome requires ligation of the segmental epineural vessels over 8 to 10 cm in order to free up and mobilize the nerve along its new course. As a result, the blood supply of ulnar nerves already compromised by entrapment is likely to be harmed even more. For the past three years we chose to perform simple decompression of the nerve with or without external/internal neurolysis on 33 patients (34 arms). After a follow-up time of six months to three years (mean 12 months), the outcome was evaluated by complete examination of hand function and by electrophysiologic studies. Four patients were excluded from the analysis due to short follow-up times. Four underwent decompression for mild entrapment symptoms, six for moderate symptoms, and 19 for severe symptoms. The functional outcome was rated as excellent in 26.7% (eight patients) and as good in 33.3% (ten patients). In group 3 (severe entrapment symptoms), seven patients (23.3%) showed moderate results and in four patients (13.3%) the outcome was poor. Considering that most of our patients had severe entrapment with advanced muscle atrophy, the overall outcome of decompression was satisfactory.

Adolescent↗
PubMed1983

[Indications and methods of treatment of injuries of the peripheral nerves. Comparative clinical results of the management of the median nerve and ulnar nerve using the epineural, perineural fascicular suture and transplantation].

In the last five years we have treated 95 lesions of the peripheral nerves. There were 24 lacerations of median and 25 of ulnar nerve. The results of treatment of median and ulnar nerve with epineural, perineural fascicular suture and transplant have been compared. The authors have tested the localisation of touch, two-point discrimination, recognition of small items, basic positions of the hand, precise action of the hand, and the motor power according to the Seddon's scale. The results were divided in excellent (2PD: 3-5 mm, power 5), very good (2PD: 6-9 mm. power 4), good (2 PD: 10-12 mm. power 4), fair (2PD: over 12 mm. power 3) and poor. The good results are groups excellent, very good and good. There were 44% good results using perineural fascicular suture of median nerve and 50% of ulnar nerve. The other methods have given poor results.

Humans↗
PubMed1995

Bilateral snapping triceps tendon after bilateral ulnar nerve transposition for ulnar nerve subluxation.

Reports of subluxation of the medial head of the triceps tendon over the medial epicondyle are rare. This may be associated with symptomatic ulnar nerve compression at the elbow. We report a case of bilateral snapping triceps tendon after bilateral ulnar nerve release at the elbow with anterior submuscular transposition. Careful inspection of the triceps tendon in flexion and extension at the time of the ulnar nerve submuscular transposition may prevent this potential complication.

Elbow Joint↗
PubMed1997

Transfer of a branch of the anterior interosseus nerve to the motor branch of the median nerve and ulnar nerve.

OBJECTIVE: To explore the applied microsurgical anatomy of the intrinsic hand muscles and related nerves after nerve injuries in the wrist region and to report the results of new technique for the restoration of motor functions of the injured nerves. METHODS: Seven fresh forearm amputation specimens were employed for studying the anatomical and microsurgical characteristics of the relevant tissues. Transfer of the pronator quadratus branch of the anterior interosseous nerve (PBAN) to the recurrent branch of the median nerve (RBMN) and the deep branch of the ulnar nerve (DBUN) to restore the functions of the intrinsic hand muscles was performed on 20 patients from April 1979 to January 1994. Fourteen patients were followed up for 3-9 years with an average of 5 years and 8 months. RESULTS: The RBMN, DBUN and PBAN had approximately the same lengths of diameter and similar amounts of fascicles and nerve fibers so that after nerve transfer, the possibilities of misdirected connections were greatly reduced. In the latest follow-up, normal muscle strength was regained in 3 patients, grade VI strength in 6, grade III strength in 3 and grade II strength in 2. CONCLUSION: This new technique is able to restore the intrinsic hand muscular functions after median or ulnar nerve injuries in the wrist region or distal forearm.

Adolescent↗
PubMed1996

Anatomic delineation of the ulnar nerve and ulnar artery in relation to the carpal tunnel by axial magnetic resonance imaging scanning.

In a number of publications the distal branches of both the ulnar artery and ulnar nerve have been identified as being positioned ulnar to the hook of the hamate. We undertook a magnetic resonance imaging project in patients who presented for carpal tunnel release to determine how far radially vital structures of Guyon's canal may be located and if they may overlap the carpal tunnel at the hook of the hamate. Cross-sectional magnetic resonance imaging scans of 20 patients were performed prior to carpal tunnel release with the wrist positioned in neutral, flexed, and extended positions. Linear measurements were made either radial or ulnar to the hook of the hamate taken as the reference point. In the neutral position, the ulnar nerve was found to be, on average, 3.6 mm ulnar to the hook of the hamate (range of 5.8 mm radial to 7.5 mm ulnar). The ulnar artery averaged 0.7 mm to the radial side of the hook of the hamate (range 7.8 mm radial to 2.8 mm ulnar). Guyon's canal extended 28% of the way across the carpal ligament (range 9 to 63%). With the wrist in flexion and extension, there was an ulnar displacement and a radial displacement, respectively, of these structures relative to the hook of the hamate.

Carpal Bones↗
PubMed1998

The role of ulnar nerve transposition in ulnar nerve repair: a cadaver study.

Ulnar nerve transposition at the elbow is recommended to diminish nerve gaps during neurorrhaphy. We undertook a cadaver study to determine the gap distance that can be overcome by subcutaneous transposition at the elbow, evaluating lacerations 2.0 cm distal to the medial epicondyle and 2.0 cm proximal to the wrist crease. With a 100-g load on each nerve stump, gaps that could be overcome were measured before and after transposition in different elbow and wrist positions. For the distal forearm lacerations, wrist position significantly affected nerve gap, while transposition and elbow position did not. Nerve gap was significantly reduced by approximately 11 mm with wrist flexion from 0 degrees to 45 degrees. For proximal forearm lacerations, gap distance was significantly affected by transposition and was dependent to a greater extent on the interaction between transposition and elbow position, with wrist position having no effect. A clinically relevant scenario for the proximal laceration compared the pretransposition gap with the elbow and wrist at neutral with the posttransposition gap with the elbow and wrist flexed. Posttransposition gap reduction, with elbow and wrist flexion at 45 degrees, was approximately 9 mm and was not significant. To span a gap near the elbow, we estimate that more than 45 degrees of elbow flexion is required.

Aged↗
PubMed1981

Lipofibromatous hamartoma of median nerve and ulnar nerve: surgical treatment.

Seven cases of lipofibromatous hamartomas of the median and ulnar nerve wee seen. Three were treated conservatively, and four had radical surgical excision. The three conservatively treated patients, seen over 20 years ago, were lost to follow-up. Four hand centers stated that these masses do not regress on conservative treatment. Follow-up evaluation of 1, 4, 9, and 20 years of the patients treated by radical surgery indicated that all patients had a useful, functional hand. All had complete range of motion in flexion and extension. Moving two-point discrimination was normal in two and abnormal in the older patient and in the patient whose tumor was resected at the wrist. If surgical treatment is decided upon for the large tumor masses, it is recommended that it be done early, distal to the wrist, and at age 2. Electromyographic studies do not demonstrate sensory nerve regeneration. Compensatory sensibility results obtained must be due to the reeducational capability in children. Radical surgical excision without nerve grafting is not recommended in adults because the potential for reeducation is limited. Some surgeons recommend and do nerve grafting following resection of the tumor when there are no remaining identifiable nerve fibers.

Adult↗
PubMed1989

[Elastic behavior of the median nerve and ulnar nerve in situ and in vitro].

This study was performed to investigate the mechanical properties of the median and the ulnar nerve in ten fresh cadaver extremities in situ and in a second series in vitro in a strain controlled testing equipment. In situ the nerves were fixed in the equipment at the level of the insertion of the pectoral muscle. The extensions of the nerves were tested in the undissected bed of the nerve with loads from 2 to 25 Newtons. The extension rate of three sections was measured: A: Axilla-wrist, B: Axilla-forearm, C: Axilla-elbow. On the contralateral arm the section D: Axilla-wrist was measured after cutting the nerve's branches without destroying the nerve's bed. The values of the section A, B, and C were significantly different. The nerves were less extensible the more distal the load was fixed. The values of the two sections with equal length A, without, and D, after cutting the nerve's branches also were significantly different (p less than 0.001). The in vitro series showed that the nerves were more extensible after removal of the connective tissue of the nerve's bed.

Biomechanical Phenomena↗
PubMed1994

Variations of the ulnar nerve and ulnar artery in Guyon's canal: a cadaveric study.

In 23 cadaveric hands the hypothenar region was studied and this report is about the anatomical boundaries and contents of Guyon's Canal. It was noted that the contents of Guyon's canal exit through two distinct areas termed the deep distal hiatus and superficial distal hiatus. A variation in the course of the deep branch of the ulnar artery, reported to be infrequent, was found to be present in 74% of the specimens. We concluded that the ulnar artery exists distal to the space described by Guyon. When a release of the ulnar nerve is undertaken, surgery should not only open the roof of Guyon's space but also the fibrous arcade of the deep distal hiatus.

Adult↗
PubMedDate not supplied

Ulnar nerve palsy at the elbow after surgical treatment for fractures of the olecranon.

Despite close proximity of the fracture site to the nerve, ulnar nerve palsy after surgery for fracture of the olecranon is uncommon. We examined 18 cases of fracture of the olecranon treated surgically retrospectively to see if there were any characteristics common to 4 cases of ulnar nerve palsy. Three cases of palsy with a comminuted fracture had fair or poor reduction as revealed by both the lateral and anteroposterior radiographs taken at the time of surgery. The other case, with little displacement of the fragment, had osteoarthritic changes at the medial side of the elbow. The mechanism of development of ulnar nerve palsy is considered to be multifactorial. However, it should be noted that evaluation of reduction of the fracture, not only on a lateral radiograph but also on an anteroposterior radiograph at the time of surgery, is important to prevent the ulnar nerve from being jeopardized.

Adult↗
PubMed2002

Anterior interosseous nerve transfer to the motor branch of the ulnar nerve for high ulnar nerve injuries.

Primary repair of a high ulnar nerve injury results in a uniformly poor outcome as a result of the great distance between the site of injury and the innervated muscles. In this study the authors present two cases of high ulnar nerve injuries in adults. Reconstruction was performed using the distal branch of the anterior interosseous nerve, which was transferred to the distal motor branch of the ulnar nerve. This resulted in timely return of function to the ulnar-innervated intrinsic muscles of the hand, which was documented further by electromyography. For high ulnar nerve injuries, this type of nerve transfer is a much better approach than the traditional primary neurorrhaphy.

Adult↗
PubMed2002

Distal anterior interosseous nerve transfer to the deep motor branch of the ulnar nerve for reconstruction of high ulnar nerve injuries.

Proximal ulnar nerve injuries can result in loss of intrinsic muscle function of the hand, and distal nerve transfers provide nerve coaptation close to the target muscle. This retrospective chart review evaluated patient outcome following a distal nerve transfer of the anterior interosseous nerve (AIN) to the deep motor branch of the ulnar nerve. There were eight patient charts reviewed, three women, and five men. The mean patient age was 38 years (standard deviation: 22 years). The mean time from injury to surgery was 3 months (standard deviation: 3 months), and mean postoperative follow-up time was 18 months (standard deviation: 11 months). All patients had reinnervation of the ulnar nerve intrinsic hand muscles with improved postoperative lateral pinch and grip strength. One patient had a secondary tendon transfer. No functional deficit in performing tasks in pronation was reported. The distal nerve transfer of the AIN to the deep motor branch of the ulnar nerve provides good reinnervation of the ulnar-nerve-innervated intrinsic muscles of the hand.

Adult↗
PubMed1999

Reconstruction of high ulnar nerve lesions by distal double median to ulnar nerve transfer.

Ulnar nerve lesions around the elbow often carry an unfavorable prognosis due to insufficient sensory and intrinsic muscle recovery. We present a series of 7 cases in which restoration of ulnar innervated intrinsic muscles of the hand and of skin sensibility was achieved. This was accomplished by a distal connection of the anterior interosseous nerve and the superficial sensory palmar branch of the median nerve to the motor and sensory components of the ulnar nerve at Guyon's canal. The length of the follow-up period ranged from 1 to 3.5 years. Results were graded by the Highet-Zachary scale. Good motor and sensory recovery was obtained in 6 cases; only return of protective sensation occurred in the remaining case.

Adult↗
PubMed1970

Results of anterior transposition of the ulnar nerve for ulnar neuritis.

A clinical and electrophysiological followup study was done on 23 patients with ulnar neuritis treated by surgical transposition of the nerve at the elbow. Pain was relieved in all those affected and other sensory symptoms showed some degree of improvement in most. Weakness tended to persist, but recovery of full use of the hand followed operation in 74%. Muscle wasting was the least likely to improve. The chance of recovery after operation was greatly reduced in patients in whom preoperative symptoms had been present for more than one year.

Elbow↗