Tardy ulnar nerve palsy is ulnar neuropathy at or around elbow and commonly evaluated in the electromyography laboratory. However, ulnar neuropathy at the elbow due to neurofibroma is rare. Neurofibromas are tumors that arise within nerve fasciculi and anywhere along a nerve from dorsal root ganglion to the terminal nerve branch. We report one case of ulnar neuropathy at the elbow due to neurofibroma. Patient had paresthesia on the left 5th finger and there had been left hypothenar atrophy since 2 months ago. Tinel's sign was positive at left elbow. As a result of electromyography, there were suggestive of right ulnar neuropathy at or around elbow, referred to as tardy ulnar nerve palsy. Ultrasonography showed a diffuse tortuous thickening with multiple neurofibromas arising from individual fascicles of the ulnar nerve in cubital tunnel area. Surgery was then performed to release cubital tunnel of left elbow, then the patient's symptoms improved.
Atrophy ; Elbow ; Electromyography ; Fingers ; Ganglia, Spinal ; Humans ; Neurofibroma ; Neurofibromatoses ; Paresthesia ; Ulnar Nerve ; Ulnar Neuropathies ; Ultrasonography

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

In the evaluation of peripheral nerve injury, nerve conduction studies and needle electromyography mainly focus on anatomical localization and functional evaluation of lesions. Whereas neuromuscular ultrasound has an advantage in structural assessment of lesions. In addition, muscle ultrasound can also be used to demonstrate muscle denervation without causing pain. We report a case of traumatic ulnar nerve injury at hand in which muscle ultrasound contributed to precise localization by provided detailed information about the extent of muscle denervation.
Electromyography ; Hand ; Humans ; Muscle Denervation ; Needles ; Neural Conduction ; Neuroanatomy ; Peripheral Nerve Injuries ; Peripheral Nerves ; Ulnar Nerve ; Ulnar Neuropathies ; Ultrasonography

Humeral medial epicondyle fractures constitute around 15% of pediatric elbow fractures. Up to 60% occur in association with elbow dislocations. Knowledge of potential imaging pitfalls when examining acute elbow fractures in children contributes significantly to accurate diagnosis. Nevertheless, management of missed pediatric medial epicondyle fractures has rarely been reported. We present an 11-year-old boy with a neglected and severely displaced medial epicondyle fracture with concurrent ulnar nerve palsy. We performed neural decompression, fragment excision, and muscular and capsuloligamentous reconstruction of the medial elbow. This study demonstrates that the surgical outcome of a late presenting fracture can be satisfactory in terms of function and neural recovery. It also underscores the importance of careful interpretation of elbow imaging including normal anatomic variants.
Adolescent* ; Child ; Decompression ; Diagnosis ; Dislocations ; Elbow ; Humans ; Male ; Ulnar Nerve* ; Ulnar Neuropathies*

The dorsal ulnar cutaneous nerve (DUCN) is the sensory branch of ulnar nerve supplying sensation to the dorsal ulnar aspect of the hand. Isolated DUCN injury is known rare. We report 3 cases of isolated DUCN injury caused by stretch injury and mild blunt injury during activities of daily living. Isolated DUCN injury may more frequently occur than we thought. Nerve conduction study and ultrasonography are useful method to localize the lesion and to evaluate the structural etiology.
Activities of Daily Living* ; Hand ; Methods ; Neural Conduction ; Sensation ; Ulnar Nerve ; Ulnar Neuropathies ; Ultrasonography ; Wounds, Nonpenetrating

This case report describes a severe nerve injury to the right ulnar nerve, caused by bee venom acupuncture. A 52-year-old right-handed man received bee venom acupuncture on the medial side of his right elbow and forearm, at a Traditional Korean Medicine (TKM) clinic. Immediately after acupuncture, the patient experienced pain and swelling on the right elbow. There was further development of weakness of the right little finger, and sensory changes on the ulnar dermatome of the right hand. The patient visited our clinic 7 days after acupuncture. Electrodiagnostic studies 2 weeks after the acupuncture showed ulnar nerve damage. The patient underwent steroid pulse and rehabilitation treatments. However, his condition did not improve completely, even 4 months after acupuncture.
Acupuncture* ; Bee Venoms* ; Bees* ; Elbow ; Fingers ; Forearm ; Hand ; Humans ; Medicine, Korean Traditional ; Middle Aged ; Rehabilitation ; Ulnar Nerve* ; Ulnar Neuropathies

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*

The characteristic of primary osteoarthritis of the elbow is marginal osteophyte and loose body formation with relatively preserving cartilage, manifesting as a painful and limited motion arc. In moderate degenerative changes, a debridement that remove the bony impingement as a basis of the surgical treatment can be performed by arthroscopic as well as open procedure. This article tries to suggest the indication of arthroscopic or open procedure by comparative analyzing the advantages and disadvantages of each method. As a result, arthroscopic procedure may be recommended when the range of motion is greater than 100° and main symptom is pain, on the other hand open debridement may be recommended when the range of motion is less than 100°, main symptom is limited motion, especially further flexion and ulnar neuropathy is accompanied.
Arthroscopy* ; Cartilage ; Debridement ; Elbow* ; Hand ; Methods ; Osteoarthritis* ; Osteophyte ; Range of Motion, Articular ; Ulnar Neuropathies

The reported cases of upper limb nerve injury followed by needle procedure such as intramuscular injection or routine venipuncture are rare. However, it should not be overlooked, because neurological injury may cause not only minor transient pain but also severe sensory disturbance, hand deformity and motor dysfunction with poor recovery. Recognizing competent level of anatomy and adept skill of needle placement are crucial in order to prevent this complication. If a patient notices any experience of abnormal pain or paresthesia during the needle procedures, an administrator should be alert to the possibility of nerve injury and should withdraw the needle immediately. Careful monitoring of the injection site for hours is required for early detection of nerve injury.
Administrative Personnel ; Catheterization, Peripheral ; Hand Deformities ; Humans ; Injections, Intramuscular* ; Median Neuropathy ; Needles ; Paresthesia ; Peripheral Nerve Injuries ; Phlebotomy* ; Radial Neuropathy ; Ulnar Neuropathies ; Upper Extremity*

PURPOSE: The aim of this study was to determine the effectiveness of arthroscopic debridement with mini-open ulnar nerve decompression in primary osteoarthritis of the elbow with ulnar neuropathy. MATERIALS AND METHODS: Between May of 2006 and July of 2014, a total of 43 patients who had undergone surgery for primary osteoarthritis of the elbow with ulnar neuropathy were included in this study. We divided the subjects into two groups according to the method of surgery: group 1 (n=18) received mini-open ulnar nerve decompression only, and group 2 (n=25) received arthroscopic debridement with mini-open ulnar nerve decompression. Patients were assessed for the following clinical outcomes: visual analogue scales (VAS) score, range of motion of the elbow joint, Mayo elbow performance score (MEPS), and disabilities of the arm, shoulder and hand (DASH) at the time before surgery and 6 months after surgery. We analyzed the recovery of the ulnar nerve by the McGowan grade and Bishop rating score preoperatively and at 6 months after the surgery. RESULTS: The VAS score, range of motion of the elbow joint, MEPS, and DASH showed significant statistical difference after the surgery (p <0.05). However, between the 2 groups, there was no significant difference. For the McGowan grade, all cases of both groups–except one case each group–showed at least one grade improvement. Moreover, group 2 showed a greater significant difference than group 1 (p=0.001). At the final follow-up, according to the Bishop rating score, group 2 had a greater significant difference than group 1 (p=0.036). CONCLUSION: Arthroscopic debridement with mini-open ulnar nerve decompression in primary osteoarthritis of the elbow with ulnar neuropathy is a useful technique, which has several advantages, including the benefits associated with a minimally invasive surgery and also the improvement of elbow joint function and excellent recovery of the ulnar nerve.
Arm ; Arthroscopy ; Debridement* ; Decompression* ; Elbow Joint ; Elbow* ; Follow-Up Studies ; Hand ; Humans ; Methods ; Minimally Invasive Surgical Procedures ; Osteoarthritis* ; Range of Motion, Articular ; Shoulder ; Ulnar Nerve* ; Ulnar Neuropathies* ; Weights and Measures