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Ulnar neuropathy at the elbow: Difference between revisions

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{{Lead rewrite|date=August 2024}}
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In general, ulnar [[Peripheral neuropathy|neuropathy]] will result in symptoms in a specific anatomic distribution, affecting the little finger, the ulnar half of the ring finger, and the [[Hand#Intrinsic|intrinsic muscles]] of the hand.
 
The specific symptoms experienced in the characteristic distribution depend on the specific location of ulnar nerve compression. The hallmark symptoms of ulnar neuropathy at the elbow (cubital tunnel syndrome) is paresthesia (tingling). This can progress to a loss of sensibility. Muscle weakness is usually experienced as a loss of dexterity.
 
[[Ulnar neuropathytunnel syndrome]] at the wrist ([[ulnar tunnelneuropathy|ulnar syndromeneuropathy at the wrist]]) is associated with variable symptoms, as the ulnar nerve separates near the hand into distinct motor and sensory branches.
 
In [[cubital tunnel syndrome]] (ulnar neuropathy at the elbow), sensory and motor symptoms tend to occur in a certain sequence. Initially, there may be intermittent paresthesia and loss of sensibility of the small and ulnar half of the ring fingers. Next is constant numbness (loss of sensibility). The final stage is intrinsic hand muscle atrophy and weakness.
 
In contrast, when ulnar neuropathy occurs at the wrist (ulnar tunnel syndrome), motor symptoms predominate. There may be an ulnar claw hand from imbalance between the muscles innervated by the ulnar nerve in the forearm (which are functioning normally) and those in the hand (which are weak). The back of the hand will have normal sensation.<ref name="pmid11299442">{{cite journal |last1=Aguiar |first1=Paulo Henrique |last2=Bor-Seng-Shu |first2=Edson |last3=Gomes-Pinto |first3=Fernando |last4=Almeida- Leme |first4=Ricardo Jose de |last5=Freitas |first5=Alexandre Bruno R. |last6=Martins |first6=Roberto S. |last7=Nakagawa |first7=Edison S. |last8=Tedesco-Marchese |first8=Antonio J. |title=Surgical management of Guyon's canal syndrome, an ulnar nerve entrapment at the wrist: report of two cases |journal=Arquivos de Neuro-Psiquiatria |date=March 2001 |volume=59 |issue=1 |pages=106–111 |doi=10.1590/S0004-282X2001000100022 |pmid=11299442 |doi-access=free }}</ref>
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===Pathoanatomy===
The most common location of ulnar nerve compression at the elbow is within the [[cubital tunnel]]. The symptoms and signs associated with this pathophysiology are known as '''[[cubital tunnel syndrome''']].<ref name="pmid33115358">{{Cite journal |last1=Thakker |first1=Arjuna |last2=Gupta |first2=Vinay Kumar |last3=Gupta |first3=Keshav Kumar |date=December 2020 |title=The Anatomy, Presentation and Management Options of Cubital Tunnel Syndrome |url=https://pubmed.ncbi.nlm.nih.gov/33115358 |journal=The Journal of Hand Surgery Asian-Pacific Volume |volume=25 |issue=4 |pages=393–401 |doi=10.1142/S2424835520400032 |issn=2424-8363 |pmid=33115358|s2cid=226051048 }}</ref><ref name="pmid17267675" /> The tunnel is formed by the [[medial epicondyle of the humerus]], the [[olecranon]] process of the ulna and the tendinous arch joining the humeral and ulnar heads of the [[flexor carpi ulnaris]] muscle (the cubital tunnel retinaculum; aka Osborne ligament).<ref name="Moore-2010">{{cite book|last=Moore|first=Keith L.|title=Clinically Oriented Anatomy 6th Ed.|year=2010|publisher=Lippincott, Williams and Wilkins|location=Baltimore, MD|isbn=978-07817-7525-0|page=770}}</ref>
 
====Etiology====
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==See also==
* [[Cervical Vertebraevertebrae]]
* [[Ulnar neuropathy]]
* [[Ulnar tunnel syndrome]]
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