Traumatic ulnar neuropathy from jet injection: case report.

The usefulness and relative safety of the technique of jet injection, mainly used in mass immunization, have been well established. A patient who developed a traumatic ulnar neuroma at the site of jet injection of swine flu vaccine is reported. This unusual and previously unreported complication of this procedure is thought to have occurred because of the patient's extremely small size and small muscles.     

Radioulnar synostosis following an isolated fracture of the ulnar shaft. A case report

In the case of a 19-year-old man, overuse of his nondominant forearm resulted in a radioulnar synostosis. Despite the persistence of the synostosis, the patient adapted to loss of forearm rotation. No further treatment was necessary. Isolated fractures of the ulnar shaft are slow in healing. Several authors observed that early function may be beneficial. However, excessive activity causing motion at the fracture site may cause subperiosteal hemorrhage and soft tissue trauma and may stimulate exuberant callus formation. Fractures of the ulnar shaft, even undisplaced, need to be immobilized to prevent overuse.     

An anomalous flexor digitorum superficialis muscle-tendon unit associated with ulnar neuropathy. A case report

A previously undescribed accessory flexor digitorum superficialis muscle-tendon unit was discovered on surgical exploration of the wrist in an 18-year-old girl with symptoms of distal ulnar neuropathy and a volar soft-tissue mass. Excision of the muscle-tendon unit resulted in complete resolution of symptoms. The preoperative diagnosis of an accessory muscle is difficult, being commonly mistaken for synovitis, ganglia, or tumor.     

Surgical treatment of ulnar neuropathy.

Ulnar neuropathy is a well recognized clinical entity caused by a variety of pathological lesions around the elbow. The characteristic features include paresthesia and numbness in the little finger and medial half of the fourth digit, weakness of the small muscles of the hand innervated by the ulnar nerve, and a positive Tinel's sign. The diagnosis is confirmed by electrophysiological studies. Current methods of treatment are anterior transposition, neurolysis and medial epicondylectomy of the humerus. Forty-four patients with ulnar neuropathy are described in the present report. Most were males with a median age of 45. The left side was involved more frequently. Results of subcutaneous anterior transposition and medial epicondylectomy are presented along with a review of the literature.     

Traumatically induced lymphangioma of the ulnar nerve. Case report

Lymphangiomas, benign hamartomatous lesions involving lymphatic tissue, result from a failure of lymphatic channels to communicate with the venous system or normal lymphatic channels. The authors describe a case in which a lymphangioma arising within the ulnar nerve developed after trauma to the same area. This is the second reported case of a lymphangioma that originated from a peripheral nerve and the first case in which the lesion was associated with trauma. The authors propose that a lymphangioma involving the peripheral nerve may be the result of trauma.     

Wartenberg's disease--superficial radial neuropathy. Case report]

This paper describes a case of surgical treatment in 55 years old patient with superficial radial neuropathy.     

Cubonavicular synostosis. A case report

Tarsal coalition is an entity with a great number of reported variants and with many unsolved questions, from its physiopathology to its treatment. Because of its exceedingly low frequency, we report a case of cubonavicular coalition. The symptoms cleared with conventional analgesic therapy, and no other therapeutic measures were required.     

Nonfamilial hyperphosphatemic tumoral calcinosis with ulnar neuropathy

We present a case of multiple large juxta-articular painless masses involving both the elbows and right hip in a 27-year old south Asian male who presented with ulnar neuropathy and constitutional symptoms. Radiology, blood investigations and biopsy confirmed it to be hyperphosphatemic tumoral calcinosis. Patient was also diagnosed with an extremely rare association, testicular microlithiasis. Complete surgical excision with low phosphate diet resulted in complete neurological recovery and no recurrence at 30 months. Tumoral calcinosis should be considered in the differential diagnosis of a case with multiple, symptomatic juxta-articular masses.     

Aspergillus parasellar abscess mimicking radiation-induced neuropathy. Case report

BACKGROUND: Transsphenoidal surgery is a safe procedure for treatment of pituitary adenomas. However, several complications, including post-surgical infection, are known. We describe a case of Aspergillus parasellar abscess that presented with cranial neuropathies following transsphenoidal surgery and radiosurgery. We initially diagnosed the case as radiation-induced neuropathies, which delayed the detection of Aspergillus. CASE DESCRIPTION: A 55-year-old man underwent transsphenoidal surgery for a pituitary adenoma that presented with pituitary apoplexy. Dexamethasone had been continuously administered for hypocortisolism probably caused by pituitary apoplexy. Four years later, radiosurgery was performed for a relapse in the right cavernous sinus. Another 4 years later, he developed painful right ophthalmoplegia, right ptosis, and bilateral visual impairment, successively. We initially suspected that the painful ophthalmoplegia and ptosis were because of radiation-induced cranial neuropathies; however, results of magnetic resonance (MR) imaging and his clinical course were not consistent with those of radiation-induced neuropathies. Therefore, we performed exploratory surgery that revealed a subdural abscess on the planum sphenoidale. Culture of a specimen grew Aspergillus fumigatus. CONCLUSION: Intracranial fungal abscess is a fatal complication unless it is treated early. It is thus important to consider the possibility of parasellar infection and differentiate it from radiation-induced cranial neuropathies when a patient presents with cranial neuropathies after transsphenoidal surgery and radiosurgery.     

Distal ulnar neuropathy. Clinical and electrophysiologic aspects

Nine patients with distal ulnar neuropathy were studied. Weakness of the hand muscles was the only abnormality in six patients; abnormal sensation was present in two patients. The cause was known in seven patients: chronic "occupational" nerve compression occurred in three meat packers and two long-distance bicyclists--acute blunt trauma to the palm of the hand in two patients. Our study indicates that electromyographic abnormalities in distal ulnar neuropathy are more variable than reported. The electromyographic findings indicated predominant axonal degeneration of motor nerve fibers, contrasting also to electromyographic abnormalities seen in entrapment neuropathies. The reasons for these differences are discussed.     

Recurrent ulnar nerve dislocation at the elbow. Report of a non-traumatic case with ulnar entrapment neuropathy

An unusual case of habitual recurrent ulnar nerve dislocation at the elbow is described. The case was complicated by non-traumatic ulnar entrapment neuropathy interfering with the patient's profession as a musician (cello).     

Pressures recorded in ulnar neuropathy

The pressure between the ulnar nerve and the arcade bridging the two heads of the flexor carpi ulnaris muscle was recorded peroperatively in ten patients with electrophysiologically confirmed ulnar neuropathy at the elbow. At rest, with the elbow extended, pressures ranged from 0 to 19 mm Hg but increased in flexion and during isometric contraction of the flexor carpi ulnaris muscle to maximal values above 200 mm Hg.     

Pressures recorded in ulnar neuropathy

The pressure between the ulnar nerve and the arcade bridging the two heads of the flexor carpiulnaris muscle was recorded peroperatively in ten patients with electrophysiologically confirmed ulnar neuropathy at the elbow. At rest, with the elbow extended, pressures ranged from 0 to 19 mm Hg but increased in flexion and during isometric contraction of the flexor carpi ulnaris muscle to maximal values above 200 mm Hg.     

Reoperation in high ulnar neuropathy

Twenty-two reoperations were done on 16 arms in 14 patients who had previously been unsuccessfully treated by neurolysis for cubital tunnel syndrome. For the first reoperation subcutaneous transposition was chosen for 10 arms, and submuscular transposition for six. The symptoms were cured or improved in seven arms, eight were unchanged and one was made worse. In six arms in which first neurolysis and then subcutaneous transposition had been unsuccessful, submuscular transposition was carried out. Five patients were improved or cured, and the symptoms were unchanged in one. Reoperation after ulnar neurolysis therefore gave satisfactory results in about half the cases. Submuscular transposition carried out as a second reoperation may be useful in cases in which subcutaneous transposition had not been successful.     

Bilateral femoral nerve neuropathy following blunt trauma. Case report

A unique case of bilateral compressive injury of the femoral nerves is reported in a 19-year-old man. Traumatic femoral nerve neuropathy following operative injury, penetrating injury, anticoagulant therapy with hemorrhage, and stretch injury has been described previously, and the literature concerning this unusual clinical problem is reviewed. Bilateral traumatic femoral nerve neuropathy resulting from compressive injury has not been previously reported.