• Archives of Plastic Surgery
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• 제36권1호
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• pp.84-88
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• 2009

Purpose: Compression of the ulnar nerve in the ulnar tunnel is a relatively uncommon condition. Many authors have described several etiologies of ulnar nerve compression. We experienced two cases of ulnar nerve compression in the ulnar tunnel due to an anomalous pulsatile S - shaped ulnar artery. Methods: Case 1: A 51 - year - old man was referred with numbness and paroxysmal tingling sensation along the volar side of the ring and little fingers of his right hand for 6 months. When exploration, the ulnar artery was pulsatile S - shaped and was impinging on the ulnar nerve. To decompress the ulnar nerve, the tortuous ulnar artery was mobilized and translocated radially onto the adjacent fibrous tissue. Case 2: A 41 - year - old man was referred with tingling sensation on the 4 th, 5 th finger of the right hand for 4 months. Sensory nerve conduction velocities of the ulnar nerve was delayed. Preoperative 3D angio CT scan showed an anomalous S - shaped ulnar artery. Same operation was done. Results: The postoperative course was uneventful. After decompression, paroxysmal tingling sensation decreased to less than 1 minute per episode, occurring 1 - 2 times a day. After 4 months, they had no more episodes of numbness and tingling sensation. Examination demonstrated good sensation to pinprick and touch on the ulnar aspect of the hand. Conclusion: We report two cases of ulnar nerve compressive neuropathy that was caused by an anomalous pulsatile S - shaped ulnar artery in the ulnar tunnel. Although this is an unusual cause of ulnar nerve compression, the symptoms will not spontaneously resolve. The prompt relief of compressive neuropathic symptoms following the translocation of the impinging ulnar artery from the affected ulnar nerve onto adjacent tissue proved that the ulnar nerve compression is due to the anomalous vessel.

• 대한한의학회지
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• 제26권1호
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• pp.11-17
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• 2005

This study was carried out to identify the components of the human heart meridian muscle, the regional muscle group being divided into outer, middle, and inner layers. The inner parts of the body surface were opened widely to demonstrate muscles, nerves, blood vessels and to expose the inner structure of the heart meridian muscle in the order of layers. We obtained the following results; $\cdot$ The heart meridian muscle is composed of muscles, nerves and blood vessels. $\cdot$ In human anatomy, the difference between terms is present (that is, between nerves or blood vessels which control the meridian muscle and those which pass near by). $\cdot$ The inner composition of the heart meridian muscle in the human arm is as follows: 1) Muscle H-l: latissimus dorsi muscle tendon, teres major muscle, coracobrachialis muscle H-2: biceps brachialis muscle, triceps brachialis muscle, brachialis muscle H-3: pronator teres muscle and brachialis muscle H-4: palmar carpal ligament and flexor ulnaris tendon H-5: palmar carpal ligament & flexor retinaculum, tissue between flexor carpi ulnaris tendon and flexor digitorum superficialis tendon, flexor digitorum profundus tendon H-6: palmar carpal ligament & flexor retinaculum, flexor carpi ulnaris tendon H-7: palmar carpal ligament & flexor retinaculum, tissue between flexor carpi ulnaris tendon and flexor digitorum superficial is tendon, flexor digitorum profundus tendon H-8: palmar aponeurosis, 4th lumbrical muscle, dorsal & palmar interrosseous muscle H-9: dorsal fascia, radiad of extensor digiti minimi tendon & extensor digitorum tendon 2) Blood vessel H-1: axillary artery, posterior circumflex humeral artery H-2: basilic vein, brachial artery H-3: basilic vein, inferior ulnar collateral artery, brachial artery H-4: ulnar artery H-5: ulnar artery H-6: ulnar artery H-7: ulnar artery H-8: palmar digital artery H-9: dorsal digital vein, the dorsal branch of palmar digital artery 3) Nerve H-1: medial antebrachial cutaneous nerve, median n., ulnar n., radial n., musculocutaneous n., axillary nerve H-2: median nerve, ulnar n., medial antebrachial cutaneous n., the branch of muscular cutaneous nerve H-3: median nerve, medial antebrachial cutaneous nerve H-4: medial antebrachial cutaneous nerve, ulnar nerve H-5: ulnar nerve H-6: ulnar nerve H-7: ulnar nerve H-8: superficial branch of ulnar nerve H-9: dorsal digital branch of ulnar nerve.

• Clinics in Shoulder and Elbow
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• 제20권4호
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• pp.236-239
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• 2017

After dual plating with a locking compression plate for comminuted intraarticular fractures of the distal humerus, the incidence of ulnar nerve injury after surgery has been reported to be up to 38%. This can be reduced by an anterior transposition of the ulnar nerve but some surgeons believe that extensive handling of the nerve with transposition can increase the risk of an ulnar nerve dysfunction. This paper reports ulnar nerve injuries caused by the incomplete insertion of a screw head in dual plating without an anterior ulnar nerve transposition for AO/OTA type C2 distal humerus fractures. When an anatomical locking plate is applied to a distal humeral fracture, locking screws around the ulnar nerve should be inserted fully without protrusion of the screw because an incompletely inserted screw can cause irritation or injury to the ulnar nerve because the screw head in the locking system usually has a slightly sharp edge because screw head has threads. If the change in insertion angle and resulting protruded head of the screw are unavoidable for firm fixation of fracture, the anterior transposition of the ulnar nerve is recommended over a soft tissue shield.

• Journal of Korean Neurosurgical Society
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• 제45권1호
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• pp.57-59
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• 2009

Guyon's canal at the wrist is not the common site of ulnar nerve compression. Ganglion, lipoma, anomalous tendon and muscles, trauma related to an occupation, arthritis, and carpal bone fracture can cause ulnar nerve compression at the wrist. However, ulnar nerve compression at Guyon's canal by vascular lesion is rare. Ulnar artery aneurysm, tortous ulnar artery, hemangioma, and thrombosis have been reported in the literature as vascular lesions. The authors experienced a case of ulnar nerve compression at Guyon's canal by an arteriovenous malformation (AVM) and the patient's symptom was improved after surgical resection. We can not easily predict vascular lesion as a cause of ulnar nerve compression at Guyon's canal. However, if there is not obvious etiology, we should consider vascular lesion as another possible etiology.

• Clinical Pain
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• 제18권2호
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• pp.97-101
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• 2019

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.

• Journal of Medicine and Life Science
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• 제15권2호
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• pp.101-104
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• 2018

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy caused by focal compression of the median nerve in the carpal tunnel. However, many patients with CTS, who are diagnosed clinically and confirmed with electrophysiological studies, complain of the sensory symptoms extends to the ulnar nerve territory. The aim of this study was to evaluate whether a dysfunction in sensory fibers of the ulnar nerve was present or not in hands with CTS patients who had extramedian spread of sensory symptoms over the hand. We retrospectively analyzed the recording of the subjects who were diagnosed with CTS within a one-year-period of time. After exclusions, 136 hands recordings of 87 patient were included. We compared the results of median and ulnar nerve sensory conduction studies between normal hands and hands with CTS. We did not detect statistically significant difference on all parameters of ulnar nerve sensory conduction studies between the normal hands and the hands with CTS. The parameters of the obtained in median nerve sensory conduction studies were statistically different between the healthy control and CTS patients. The hands with CTS showed similar rate of ulnar sensory conduction abnormalities compared with the normal hands. In conclusion, our study showed that none of the parameters in ulnar sensory nerve conduction studies differ between two groups. Accordingly, our study revealed that ulnar nerve involvement does not contribute in CTS patients underlying the spread of paresthesia extends to the ulnar nerve territory.

• Journal of Korean Neurosurgical Society
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• 제59권1호
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• pp.75-77
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• 2016

Double compression of the ulnar nerve, including Guyon's canal syndrome associated with cubital tunnel syndrome caused by the anconeus epitrochlearis muscle, is a very rare condition. We present a case of double crush syndrome of the ulnar nerve at the wrist and elbow in a 55-year-old man, as well as a brief review of the literature. Although electrodiagnostic findings were consistent with an ulnar nerve lesion only at the elbow, ultrasonography revealed a ganglion compressing the ulnar nerve at the hypothenar area and the anconeus epitrochlearis muscle lying in the cubital tunnel. Careful physical examination and ultrasound assessment of the elbow and wrist confirmed the clinical diagnosis prior to surgery.

• Clinics in Shoulder and Elbow
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• 제7권2호
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• pp.108-111
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• 2004

We experienced two cases of ulnar nerve palsy caused by a ganglion that were managed by excision of the ganglion performed concurrently with subcutaneous anterior transposition of the ulnar nerve. Satisfactory results were obtained. The possibility of ulnar nerve compression by ganglion must be considered in patient who complains rapidly progressing ulnar nerve palsy. For those cases, ultrasonography or magnetic resonance imaging seems to be helpful in obtaining preoperative diagnosis.

• Clinics in Shoulder and Elbow
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• 제2권2호
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• pp.209-213
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• 1999

It is well known that tardy ulnar nerve palsy occurs with cubitus valgus deformity as a late complication after a nonunion of lateral condyle fracture of the humerus in childhood. On the other hand, cubitus varus deformity often results from malunion of supracondylar fractures of the humerus. However, reports of tardy ulnar nerve palsy in cubitus varus deformity are few. We report a patient with bilateral cubitus varus deformities with bilateral tardy ulnar nerve palsy which was confirmed with EMG. She was treated by step cut osteotomy(DeRosa and Graziano) with sub­cutaneous anterior transposition of ulnar nerve.

• Journal of Korean Neurosurgical Society
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• 제49권2호
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• pp.139-141
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• 2011

Compression of the ulnar nerve in Guyon's canal can result from repeated blunt trauma, fracture of the hamate's hook, and arterial thrombosis or aneurysm. In addition, conditions such as ganglia, rheumatoid arthritis and ulnar artery disease can rapidly compress the ulnar nerve in Guyon's canal. A ganglion cyst can acutely protrude or grow, which also might compress the ulnar nerve. So, clinicians should consider a ganglion cyst in Guyon's canal as a possible underlying cause of ulnar nerve compression in patients with a sudden decrease in hand strength. We believe that early decompression with removal of the ganglion is very important to promote complete recovery.