BACKGROUND AND OBJECTIVES: Local compression of the ulnar nerve occurs most commonly at the elbow and optimal surgical intervention should be directed at the specific site of involvement. This study is designed to localize the more discrete region by using the method of short segment stimulation in ulnar neuropathy at the elbow. METHODS: Thirty seven patients who were diagnosed as entrapment ulnar neuropathy at the elbow by routine nerve conduction studies were investigated. Latency changes and amplitude changes including conduction block were determined by stimulating the ulnar nerve at 2cm intervals across the elbow. Six of these patients had orthopedic surgery after undergoing short segment stimulation studies. RESULT: All patients had significant latency changes(> OR =0.7msec) in specific segments by short segment stimulation and 6 patients of them showed conduction block. The most frequently involved segments were between medial epicondyle and 2cm proximal(20 patients) and between medial epicondyle and 2cm distal(9 patients). Only two patients exhibited significant latency changes between 2 and 4cm distal to the medial epicondyle, suggesting cubital tunnel syndrome. Lesions, as identified by surgery, proved to be accurately predicted by preoperative short segment stimulation in 5 of 6 patients. CONCLUSION: Short segment stimulation studies are helpful in localizing more accurate involved segment in ulnar neuropathy at the elbow. And the most commonly involved site is within 2cm of the medial epicondyle suggesting tardy ulnar nerve palsy.
Cubital Tunnel Syndrome ; Elbow* ; Humans ; Neural Conduction ; Orthopedics ; Ulnar Nerve ; Ulnar Nerve Compression Syndromes ; Ulnar Neuropathies*

We found a unique anatomical variant of the distal ulnar nerve, a neural loop encompassing the flexor carpi ulnaris during Guyon's canal exploration. Compression by the flexor carpi ulnaris during active wrist movement was suspected as the cause of ulnar neuropathy. The symptom was relieved after neurolysis and release of surrounding tissue. With regard to the ulnar side wrist pain, which is suspicious for ulnar compression syndrome at the wrist level, the surgeon should always suspect anomalous nerve branch as source of compressive neuropathic pain.
Neuralgia ; Ulnar Nerve Compression Syndromes ; Ulnar Nerve* ; Ulnar Neuropathies ; Wrist

The arcade of Struthers has been described as a possible cause of ulnar nerve compression in the elbow. This paper reports two cases of ulnar neuropathy caused by the arcade of Struthers. These observations demonstrated the importance of evaluation of the arcade of Struthers in atypical high ulnar nerve palsy.
Elbow* ; Ulnar Nerve Compression Syndromes ; Ulnar Nerve* ; Ulnar Neuropathies*

Guyon's canal syndrome is a compression neuropathy of the ulnar nerve entrapment at the wrist. Compression of the ulnar nerve at the wrist by a ganglion, lipomas, diseases of the ulnar artery, fractures of the hamate and trauma is a common etiological factor. We report on a rare case of ulnar neuropathy caused by a schwannoma at the level of Guyon's canal.
Ganglion Cysts ; Lipoma ; Neurilemmoma* ; Ulnar Artery ; Ulnar Nerve ; Ulnar Nerve Compression Syndromes ; Ulnar Neuropathies* ; Wrist

Ulnar nerve compression at the elbow can occur at any site that begins proximally at the arcade of Struthers and end distally where the nerve exits the flexor carpi ulnaris muscle in the forearm. We experienced one case of ulnar nerve palsy due to multiple ganglion cysts which had occured at the elbow joint. A complete excision of ganglion cysts and anterior transposition of the ulnar nerve were performed. The clinical result was satisfactory
Elbow Joint ; Elbow* ; Forearm ; Ganglion Cysts* ; Ulnar Nerve Compression Syndromes ; Ulnar Nerve* ; Ulnar Neuropathies*

Ulnar neuropathy at the wrist is an uncommon disease and pure ulnar sensory neuropathy at the wrist is even rarer. It is difficult to diagnose pure ulnar sensory neuropathy at the wrist by conventional methods. We report a case of pure ulnar sensory neuropathy at the hypothenar area. The lesion was localized between 3 cm and 5 cm distal to pisiform using orthodromic inching test of ulnar sensory nerve to stimulate at three points around the hypothenar area. Ultrasonographic examination confirmed compression of superficial sensory branch of the ulnar nerve. Further, surgical exploration reconfirmed compression of the ulnar nerve. This case report demonstrates the utility of orthodromic ulnar sensory inching test.
Diagnosis* ; Electrodiagnosis ; Neural Conduction* ; Ulnar Nerve ; Ulnar Nerve Compression Syndromes ; Ulnar Neuropathies ; Wrist

Compression ulnar neuropathy was predicted by Guyon in 1961,following his anatomical studies of the ulnar tunnel. Nearly a half century later Ramsey Hunt first reported isolated ulnar motor paralysis in the hand, due to chronic occupational trauma. Many authors has tried to describe the etiology of the ulnar nerve compression syndrome at or around the wrist. That is most frequently caused by ganglion, occupational neuritis, thrombosis of the ulnar artery, thickening of volar ligament or different kinds of trauma (e.g. fractures of the carpal bones). Now we experienced a case of the ulnar nerve compression syndrome at distal forearm by an anomalous branch of the ulnar nerve by piercing the distal tendon of the flexor carpi ulnaris.
Forearm ; Ganglion Cysts ; Hand ; Ligaments ; Neuritis ; Paralysis ; Tendons ; Thrombosis ; Ulnar Artery ; Ulnar Nerve Compression Syndromes ; Ulnar Nerve ; Ulnar Neuropathies ; Wrist

Cubital tunnel syndrome is the second most common compressive neuropathy. Its diagnosis is largely based on clinical findings. It has been well known that patients with mild to moderate grade of cubital tunnel syndrome have a high chance of spontaneous resolution, while those with severe degree do not. Thus, the former is treated with conservative methods initially, and the latter is indicated for surgical intervention. There are three types of surgical techniques for cubital tunnel syndrome. Of these, in-situ decompression technique has been gaining popularity as it is simpler and shows similar efficacy with less complications compared to other techniques. In this review, we deal with current concepts of the cubital tunnel syndrome pertaining to the primary clinical practice.
Cubital Tunnel Syndrome ; Decompression ; Diagnosis ; Humans ; Ulnar Nerve ; Ulnar Neuropathies*

Ulnar tunnel syndrome (UTS) is a compressive neuropathy of the upper extremity that shows various clinical symptoms according to the anatomic region of the compression site. Numerous factors may cause UTS, and most publications are case reports describing various etiologies; thus, obtaining a correct diagnosis is often challenging. Giant cell tumor of the tendon sheath (GCTTS) is well described to be a common benign soft tissue tumor of the hand; however, it is rarely reported to cause UTS. We report a case of GCTTS in Guyon's canal causing UTS that was misdiagnosed as handlebar palsy.
Diagnosis ; Giant Cell Tumors* ; Giant Cells* ; Hand ; Paralysis* ; Tendons* ; Ulnar Nerve Compression Syndromes ; Ulnar Neuropathies ; Upper Extremity

The ulnar nerve entrapment at the wrist is usually caused by carpal ganglion, occupational neuritis, ulnar artery disease, fractures of the carpal bones, tumors, rheumatioid arthritis, etc. The ganglion is the most common cause of the distal ulnar nerve entrapment. A fort-two years old woman complained of insidious motor weakness of the left hand. The electromyogram revealed distal ulnar nerve palsy. On examination, her sensibility of affected hand was normal; there were no Tinel's sign and palpable mass on the Guyon's canal and palm; there was obvious wasting of all the interossei. On surgical exploration, the deep branch of the ulnar nerve was compressed by a ganglion at the mid-palmar space, not in the Guyon's canal. Four months after removal, the clawing of the 4th and 5th fingers disappeared, and the pinch power of the left hand recovered normally seventeen months later.
Animals ; Arteries ; Arthritis ; Carpal Bones ; Female ; Fingers ; Ganglion Cysts ; Hand ; Hoof and Claw ; Humans ; Paralysis ; Ulnar Nerve Compression Syndromes ; Ulnar Nerve ; Ulnar Neuropathies