Diagnosis and Treatment of Work-Related Ulnar Neuropathy at the Elbow - 30/07/15

Doi : 10.1016/j.pmr.2015.04.002

Gregory T. Carter, MD, MS ^a,^⁎ , Michael D. Weiss, MD ^b, Andrew S. Friedman, MD ^c, Christopher H. Allan, MD ^d, Larry Robinson, MD ^e
^a St Luke’s Rehabilitation Institute, 711 South Cowley Avenue, Spokane, WA 99202, USA
^b Department of Neurology, University of Washington School of Medicine, 1959 NE, Pacific Avenue, Seattle, WA 98195, USA
^c Department of Physical Medicine and Rehabilitation, Neuroscience Institute, Virginia Mason Medical Center, Seattle, WA 98101, USA
^d Department of Orthopedic Surgery, Hand and Microsurgery Section, Harborview Medical Center, The University of Washington School of Medicine, Seattle, WA 98195, USA
^e Rehabilitation Services, Physical Medicine and Rehabilitation, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario M4N 3M5, Canada

^∗Corresponding author.

Résumé

Ulnar neuropathy at the elbow (UNE) is the second most common entrapment neuropathy after carpal tunnel syndrome and occurs most commonly at the elbow due to mechanical forces that produce traction or ischemia to the nerve. The primary symptom associated with UNE is diminished sensation or dysesthesias in the fourth or fifth digits, often coupled with pain in the proximal medial aspect of the elbow. Treatment may be conservative or surgical, but optimal management remains controversial. Surgery should include exploration of the ulnar nerve throughout its course around the elbow and release of all compressive structures.

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Keywords : Ulnar neuropathy, Ulnar entrapment, Ulnar neuritis, Cubital tunnel syndrome, Repetitive strain injury