Tardy ulnar nerve palsy after fracture non-union medial epicondyle of humerus – An unusual case

Tardy ulnar nerve palsy is a chronic clinical condition characterised by delayed onset ulnar neuropathy. Typically tardy ulnar nerve palsy occurs as a consequence of non-union of lateral condyle in child resulting in cubitus valgus deformity which ultimately is the cause of ulnar nerve palsy. However very few literature are available for tardy ulnar nerve palsy as a result of old fracture of medial epicondyle without cubitus varus or valgus deformity. We report a rare case of tardy ulnar nerve in an adult male with fracture non-union of medial epicondyle of humerus.     

Processus Supracondyloidea Humeri with Concomitant Compression of the Median Nerve and the Ulnar Nerve

Compression of the median nerve and the ulnar nerve due to the anatomical anomaly processus supracondyloidea humeri is a rare condition. a case of combined median and ulnar nerve compression is described. Diagnostics and treatment are discussed in the light of the present case history and those described in the literature. The conclusion is that the treatment should be subperiosteal resection of the process together with the origin of the pronator teres muscle.     

Humeral trochlear hypoplasia secondary to epiphyseal injury as a cause of ulnar nerve palsy

Humeral trochlear hypoplasia (HTH) is a rare condition that occasionally results in ulnar nerve palsy. A 41-year-old man developed HTH secondary to an epiphyseal injury of the trochlea incurred 33 years earlier. This may be the first report of a case of HTH caused by injury. The ulnar nerve appeared compressed by the malposition of the HTH against the medial head of the triceps brachii when the joint was flexed. The close proximity of the olecranon to the HTH also allowed the triceps brachii muscle to compress the nerve by displacing medially and overriding the bone. The condition was resolved surgically and the patient returned to his former occupation as a coal miner.     

Secondary ulnar nerve palsy in adults after elbow trauma: a report of two cases

Secondary ulnar nerve palsy, an unusual condition in which the onset of ulnar nerve dysfunction occurs 1 to 3 months after elbow trauma, can be the cause of sudden deterioration of elbow function. Initially recognized in 1899, this condition has not been reported often. We describe 2 patients who had no subjective or objective evidence of ulnar nerve dysfunction after elbow trauma but had a sudden loss of motion, pain, and clinical and electrophysiologic evidence of ulnar nerve compression at the elbow 4 to 5 weeks after trauma. Marked improvement occurred after ulnar nerve subcutaneous transposition and contracture release.     

Bilateral anomalous course of the ulnar nerve at the wrist causing ulnar and median nerve compression syndrome. Case report

The case of a patient with a bilateral compression syndrome of the ulnar and median nerves at the wrist is described. Both ulnar nerves, which were surgically explored at different times, followed an anomalous course and passed into the canalis carpi side by side with the median nerve. This variation in the course of the ulnar nerve is extremely rare and causes a unique syndrome with characteristic electromyographic patterns.     

Compression of the Deep Palmar Branch of the Ulnar Nerve by a Ganglion

A ganglion originating from the pisotriquetral joint is the most common cause of distal ulnar nerve compression. Midpalmar ganglions causing ulnar nerve compression are rare. This case describes a ganglion arising from the third carpometacarpal joint causing compression of the deep motor branch of the ulnar nerve.Investigation performed at the Toronto Western Hospital, University Health Network Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada     

Proximal ulnar nerve compression secondary to tophaceous gout

Although gout is a recognised but rare cause of carpal tunnel syndrome, compression of the ulnar nerve by tophaceous gout is rare. We describe a case of proximal ulnar nerve compression due to tophaceous gout in an 87-year-old man. Surgical decompression, with excision of the lesion and a section of the ulnar belly of Flexor Carpi Ulnaris produced symptomatic relief. This case illustrates that in the differential diagnosis of ulnar nerve palsy, tophaceous gout should be considered in those patients with known gout.     

Ganglion in the ulnar nerve groove (author's transl)]

Two cases of a rare localisation of ganglion is reported in this paper. A ganglion in the ulnar nerve presented by complete loss in ulnar nerve function. Attention is drawn to the importance of early diagnosis, and to the fact, that in cases of ulnar nerve lesions of unknown origin tumors in the ulnar groove must be considered.     

Ulnar Nerve Palsy After Elbow Arthroscopy

Reports of ulnar nerve injury as a result of elbow arthroscopy are rare in the literature. We report a case of ulnar nerve injury following arthroscopic debridement and retrograde drilling of the capitulum in a patient with symptomatic osteochondritis dissecans. The standard location of proximal medial portal placement is 2 cm proximal to the medial epicondyle at the level of the medial intermuscular septum. In this location, the ulnar nerve is protected from injury by the medial intermuscular septum. Extending this placement more proximally may negate this protection, leaving the nerve more susceptible to injury.     

肘部尺神经滑脱──流行病学调查及病理解剖观察

通过流行病学调查和病理解剖观察，提示尺神经滑脱可能与组织结构发育缺陷有关，如肱骨内上髁较小，肘管三角韧带及尺神经系膜松弛等。男女之间尺神经滑脱发生率有显著性差异。肘部尺神经滑脱并非少见，鉴于尺神经滑脱者发生肘部尺神经损害的危险性较一般人群高，一旦尺神经损害其所支配的已挛缩的手内在肌很难恢复，尺神经滑脱者是值得人们注意的肘部尺神经损害的易感人群。因尺神经滑脱者除上述结构缺陷外，更重要的是尺神经滑脱过程为重复累积性损伤，故尺神经前移以免尺神经在肱骨内上髁反复摩擦损伤为首选的治疗方法。     

Nerve sheath ganglion of the ulnar nerve

We report a case of a nerve sheath ganglion of the ulnar nerve at the canal of Guyon. This case involved a ganglion which was confined to the epineurium of the ulnar nerve. and it was completely excised without any damage to the nerve fiber. A nerve-sheath ganglion is rare, but it should be considered in the differential diagnosis of any tumor which is causing neural disturbance.     

Delayed ulnar nerve palsy secondary to ulnar artery pseudoaneurysm distal to Guyon’s canal following penetrating trauma to the hand

Compression of the ulnar nerve in Guyon’s canal is an uncommon phenomenon. Reports of ulnar nerve palsy secondary to ulnar artery pseudoaneurysm at this anatomical location are very rare and equivalent pathology just distal to this site is unheard of. Here we present such a case, which featured a delayed onset of symptoms. This followed penetrating trauma to the hand. Our methods for diagnosis, operative planning and surgical treatment are included.     

Pseudomalignant myositis ossificans of the wrist causing compression of the ulnar nerve and artery. A case report

Myositis ossificans (MO) is a condition characterised by focal, benign and self-limited idiopathic heterotopic bone formation. It is extremely rare in the hand and wrist and may lead to concomitant nerve compression. Because of the rare incidence of pseudomalignant MO at the wrist and hand, we found it of interest to report a case of this condition localised to the wrist. A 31-year-old female patient presented with swelling and pain of her left wrist. The physical examination findings, magnetic resonance imaging and Tc-99m bone scan suggested acute osteomyelitis or a tumoral condition. Incisional biopsy and pathological examination was done. The microscopic findings confirmed that the lesion was pseudomalignant MO. The lesion was removed totally and decompression of the ulnar nerve and artery was achieved. The patient regained full asymptomatic range of motion of all digits and wrist and the numbness of the fourth and fifth digits had subsided at follow-up five months later.     

Compression of the ulnar (cubital) nerve at the wrist by a supernumerary muscle

The authors report a case of anomaly of the flexor digiti minimi muscle, which extended into the forearm to be inserted 10 centimetres proximal to the carpal flexion crease on flexor carpi radialis. This anomaly was responsible for ulnar nerve compression when grasping objects with the hand. Cases of ulnar nerve compression at the wrist appear to be rare and the great majority of cases are secondary. Anatomical variants of muscles and nerves at the wrist are not exceptional, hence the importance of systematically looking for such anomalies in patients with ulnar nerve compression at the wrist. Excision of the muscle anomaly eliminated nerve compression and the associated symptoms.     

A variant of Kaplan's accessory branch of the dorsal cutaneous branch of the ulnar nerve: a case report and review of the literature

Kaplan's accessory branch is an aberrant branch of the dorsal cutaneous branch of the ulnar nerve that arises proximal to the styloid process of the ulna and courses ulnar to the pisiform. Variations of this anomaly have been described as having an end point of connection to the sensory branch of the ulnar nerve, to the motor branch of the ulnar nerve (rare), to the digital nerve at the level of the midhypothenar eminence, or to the proximal interphalangeal joint of the small finger or as running as an independent branch to the volar aspect of the small finger. We report a variant of Kaplan's accessory branch that coursed through the insertion of the flexor carpi ulnaris, a groove on the ulnar aspect of the pisiform, and connected to the ulnar nerve trunk proximal to its bifurcation into its motor and sensory branch. Based on the findings of the case presented and a review of the literature we offer a classification system for this anomaly.     

Localized nodular synovitis: a rare cause of ulnar nerve compression in Guyon's canal.

A rare case of ulnar nerve entrapment at the wrist by a nodule of localized nodular synovitis is presented. The literature is reviewed with particular reference to the causes of ulnar tunnel syndrome, the uncertainty over the origin of this type of tumor, and its tendency to recur after incomplete excision.     

Fracture of the distal part of the radius associated with severed ulnar nerve

We report a case of a severed ulnar nerve after fracture of the distal part of the radius. The most likely hypothesis is stretching of the ulnar nerve fixed by Guyon's canal and severed on the sharp edge of the proximal radius. Although very rare, this lesion must be investigated particularly in cases with marked displacement, especially ulnar and/or volar.     

Ulnar Nerve Palsy Following Closed Fracture of the Distal Radius: A Report of 2 Cases

Ulnar nerve palsy subsequent to a fracture of the distal radius is extremely rare compared to a median nerve injury. The lesion tends to occur in younger patents with a high-energy mechanism of injury and a severe injury pattern consisting of wide displacement, comminution, combined distal ulnar fracture and open fracture. The mechanism of injury can contribute to a direct contusion and traction, compression secondary to prolonged edema and tissue fibrosis, intraneural fibrosis and laceration. We report 2 cases of progressive ulnar nerve palsy subsequent to closed fractures of the distal radius. The neurological symptoms recovered in all cases who underwent nerve decompression and neurolysis at 2 or 3 months after the trauma. It is recommended that cases with high-energy, widely displaced or comminuted fractures of the distal radius be evaluated carefully for ulnar nerve as well as median nerve injury.     

Anomalous muscle causing ulnar nerve compression at Guyon's canal

Abstract We report a rare anatomical variation of an anomalous supernumerary muscle in a male cadaver. It was crossing Guyon's canal, superficial to the ulnar nerve and ulnar artery, and inserted into the aponeurosis of the little finger. This muscle could potentially cause entrapment of the ulnar nerve in Guyon's canal.