Ulnar nerve entrapment neuropathy in the forearm

Holtzman, Robert N. N.; Mark, Michael H.; Patel, Mukund R.; Wiener, Lewis M.

doi:10.1016/s0363-5023(84)80113-6

Cited by 18 publications

(8 citation statements)

References 5 publications

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“…Although ulnar neuropathy is a common complication of diabetes mellitus, the site of compression is usually in the elbow segment, not in the forearm 16. Ulnar neuropathy in the forearm is an unusual entity, with most reports relating the compression to entrapment within the distal humero‐ulnar arcade,1, 2, 7, 10, 11 with below‐elbow stimulation being performed proximal to the site of nerve injury 12. Ulnar nerve compression in the distal forearm has also been attributed to work‐related hypertrophy of the FCU,9 or to a fibrovascular pedicle nourishing a distal hypertrophic variant of the FCU as described in the case of a professional golfer 5.…”

Section: Discussionmentioning

confidence: 99%

Ulnar neuropathy in the forearm: A possible complication of diabetes mellitus

et al. 2003

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Ulnar neuropathy in the forearm is an unusual cause of hand weakness and sensory loss that is most often attributed to compression of the nerve distally within the humero-ulnar arcade (cubital tunnel). An association with diabetes mellitus, however, has not been reported. We identified four patients with type I diabetes mellitus and clinical findings suggestive of ulnar neuropathy in whom electrophysiologic testing revealed partial conduction block or abnormal temporal dispersion within the forearm segment of the ulnar nerve. Although evidence for a mild underlying polyneuropathy was present in three patients, the ulnar nerve abnormalities were disproportionately severe. In all cases, a Martin-Grüber anastomosis was excluded. Whether this lesion is due to an increased propensity to focal compression of the ulnar nerve within the humero-ulnar arcade or whether it represents a localized manifestation of the generalized polyneuropathy remains to be determined.

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Section: Discussionmentioning

confidence: 99%

Ulnar neuropathy in the forearm: A possible complication of diabetes mellitus

et al. 2003

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“…Holtzman et al (1984) present the case of a patient who was admitted with significant pressure‐activated pain localized 5 cm proximal to the distal wrist crease. The other symptoms included: claw deformity, impaired adduction, and mild atrophy of the fifth and fourth digits.…”

Section: Forearmmentioning

confidence: 99%

“…The most likely reasons for diabetes-induced entrapment are nerve ischemia caused by intravascular changes in the vasa nervorum and the presence of metabolic factors contributing to excessive accumulation of fluid in the nerve interstitial connective tissue(Acosta et al, 2003). However, the vast majority of reports of cases of UN compression in this part of the upper limb are related to CTS or pathologies of the wrist, such as UTS Holtzman et al (1984). present the case of a patient who was admitted with significant pressure-activated pain localized 5 cm proximal to the distal wrist crease.…”

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confidence: 99%

Possible points of compression of the ulnar nerve: Tricks and traps that await clinicians from an anatomical point of view

et al. 2021

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The ulnar nerve can be subject to numerous types of compression. The most common are cubital tunnel and ulnar tunnel syndromes, but there are many others with more uncommon etiologies. The existence of additional communicating branches, median nerve involvement, various types of injuries, and unusual anatomical variations can be a challenge for both diagnosis and treatment. This review presents a comprehensive depiction of ulnar nerve entrapment syndromes with particular reference to their anatomical background, risk factors, and clinical evaluation. Even common disorders can result from atypical morphological changes. It is important to be familiar with them as it is a key ability in daily medical practice.

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“…Potential sites of entrapment include (Figure 58.1): the arcade of Struthers, a thick fascial connection between the medial head of the triceps and the medial intermuscular septum located approximately 8 cm proximal to the medial epicondyle; the bony retrocondylar groove, which may be altered by trauma, arthritis, heterotopic ossification, and soft tissue masses; and Osborne's band, a thickened confluence of fascia between the two heads of FCU. [27][28][29] Congenital anatomic variations, such as cubitus valgus, an anconeous epitrochlearis muscle, a low-lying or prominent medial triceps muscle, and a hypoplastic roof of the cubital tunnel (allowing subluxation of the ulnar nerve) may also contribute to proximal ulnar compression. [27][28][29] Congenital anatomic variations, such as cubitus valgus, an anconeous epitrochlearis muscle, a low-lying or prominent medial triceps muscle, and a hypoplastic roof of the cubital tunnel (allowing subluxation of the ulnar nerve) may also contribute to proximal ulnar compression.…”

Section: Points Of Compression Cubital Tunnel Syndromementioning

confidence: 99%

Nerve compressions

Davidge

Mackinnon

2015

Plastic and Reconstructive Surgery

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Median nerveThe median nerve is formed from the medial (motor contribution) and lateral (sensory contribution) cords of the brachial plexus, then crosses over the brachial artery and courses distally along its medial aspect. In the upper arm, the median nerve lies between the medial intermuscular septum and brachialis muscle and then runs distally through the antecubital fossa under the lacertus fibrosis. The median nerve subsequently passes through the pronator teres (PT) muscle, most commonly between its superficial and deep heads. Less commonly, the median nerve will pass deep to both heads of the PT or through the substance of the superficial head. 1 After emerging from PT distally, the median nerve passes under the fibrous edge of the flexor digitorum superficialis (FDS) muscle, travelling between the FDS and flexor digitorum profundus (FDP) muscles. The median nerve gives off four groups of branches in the proximal forearm: branches to PT (proximal, superficial); branches to flexor carpi radialis (FCR) and palmaris longus (PL) (deep, ulnar); branches to FDS (deep, ulnar, more distal); and, the anterior interosseous nerve (AIN) which arises from the radial aspect of the median nerve, approximately 3 cm distal to the intercondylar line, and innervates the FDP to the index and long fingers, the flexor pollicis longus (FPL) and the pronator quadratus. 2 In the distal forearm, the median nerve becomes more superficial and courses between and just deep to the FCR and PL tendons. The palmar cutaneous branch (PCM) arises from the volar-radial aspect of the median nerve 5 cm proximal to the wrist flexion crease, and may course distally up to 6 mm ulnar to the thenar crease. 3,4 The PCM usually crosses the wrist as a single branch and then arborizes in the palm superficial to the palmar fascia. 5 At the wrist the median nerve enters the carpal tunnel along with nine tendons (FDS, FDP, FPL). The carpal tunnel is bordered dorsally by the carpal bones, ulnarly by the hamate and triquetrum, and radially by the scaphoid, trapezium and FCR

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Ulnar nerve entrapment neuropathy in the forearm

Cited by 18 publications

References 5 publications

Ulnar neuropathy in the forearm: A possible complication of diabetes mellitus

Ulnar neuropathy in the forearm: A possible complication of diabetes mellitus

Possible points of compression of the ulnar nerve: Tricks and traps that await clinicians from an anatomical point of view

Nerve compressions

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