Ulnar Nerve Trap Neuropathy (Entrapment)

Ulnar nerve entrapment neuropathy (compression) is the most common nerve compression after carpal tunnel syndrome. According to its anatomical localization, it is most common in the elbow area; Second, it is squeezed at the wrist level. With aging, the incidence of ulnar neuropathy both at the elbow and wrist level increases. Ulnar neuropathy at the elbow level is 3--8 times more common in males.

 

Symptoms of Ulnar Nerve Entrapment

 

Patients often complain of numbness and tingling in the 5th and 4th finger half. These may be accompanied by symptoms such as muscle weakness and loss of manual dexterity. In ulnar nerve compression at the level of the elbow, in addition to these symptoms, an increase in complaints occurs when standing on the elbows or when the elbow is broken. Patients may describe pain and tenderness at the elbow level that can radiate above and below. Nighttime complaints are also seriously disturbing. In severe and prolonged cases, paw hand deformity may develop, typically due to muscle atrophy.

 

Diagnosis of Ulnar Nerve Entrapment

 

The diagnosis is made by physical examination, EMG and radiological examinations together with the patient's complaints.

 

Ulnar Nerve Stress Treatment

 

Conservative Treatment

 

In ulnar nerve entrapment neuropathy, patient education and activity modification are very important in terms of avoiding repetition of movements that increase symptoms. In the first period, the aim is to reduce pain, burden and inflammation. Resting the elbow reduces inflammation and reduces symptoms. It is stated that, in patients with elbow level ulnar neuropathy, application of local steroid injection in addition to the use of splint does not provide additional benefit to the treatment. If there is no response to conservative treatment for six to 12 weeks, if progressive paralysis is accompanied by clinical evidence of prolonged lesion (muscle atrophy, paw hand), surgical treatment should be considered.

 

Surgical treatment

 

In cases that do not respond to conservative treatment, ulnar nerve decompression surgery is performed. Adequate functional results can be obtained in all of the methods used in the surgical treatment of cubital tunnel syndrome. Good results can be obtained for the cause of entrapment at the wrist level.

After ulnar nerve compression surgery, after a 10-day hand rest, the patient can continue his normal life. After the operation, numbness and tingling complaints can improve in a period that can last from a few weeks to months. Complaints of patients with severe complaints before surgery may persist, depending on the extent of the nerve damage.

Dr. Tamer Tekin