Anatomy ulnar-nerve

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Anatomy ulnar-nerve

  1. 1. Anatomy of Ulnar Nerve
  2. 2. Cubital Tunnel Syndrome• Symptoms & Signs: - sensory changes volar & dorsal ulnar 11/2 digits - Pain or Tinel’s sign at elbow - Positive elbow flexion test - weakness/atrophy of intrinsic muscles (esp. key pinch) - Wartenberg’s sign - Froment’s sign - Claw hand
  3. 3. Cubital Tunnel Syndrome• Sites of compression: - Arcade of Struthers - Medial head of triceps - Medial intermuscular septum - Arcuate lig. Of Osbourne - Aponeurosis of FCU
  4. 4. Cubital Tunnel Syndrome• Non-surgical management - night splints to keep elbow extended (static) - Soft elbow pads to prevent direct compression - Rest & activity modification - Anti-inflammatories
  5. 5. Cubital Tunnel Syndrome• Surgery - Principles: - Release of compression - Prevention of subluxation
  6. 6. Cubital Tunnel Syndrome• Surgery: - Simple decompression in situ - Medial epicondylectomy - Anterior transposition: - subcutaneous - intramuscular - submuscular - transmuscular
  7. 7. Ulnar Tunnel Syndrome (Guyon’s canal)• Symptoms & signs: - numbness volar surface ulnar 1.5digits - Intrinsic weakness - Can be pure motor, pure sensory or combination
  8. 8. Ulnar Tunnel Syndrome (Guyon’s canal)• Aetiology: - carpal ganglion - Repetitive trauma - Fracture of hook of hamate - Hypertrophied palmaris brevis - Thrombosis or aneurysm of ulnar artery
  9. 9. Ulnar Tunnel Syndrome (Guyon’s canal)• Surgery: - Release of Guyon’s canal - Ensure visualization of deep motor branch - Check for ganglion

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