What is Ulnar Nerve Compression at the Elbow?
Description
Ulnar nerve compression at the elbow causes a tingling sensation and numbness. This can be felt in the ring and small fingers. Near the inner part of the elbow, the area is tender and a feeling of electrical shock can be felt down the forearm and into the small the finger. More severe cases cause hand weakness and atrophy of the hand muscles. The symptoms of ulnar nerve compression of the elbow often worsen at night or when repeated movements of the elbow occurs.
Diagnosis
A diagnosis is derived by collecting the history of the problem from the patient. Ulnar nerve compression symptoms are very classic and an x-ray can be used to see what it causing the compression. Additional diagnostic testing includes a nerve conduction velocity or an electromyography. These tests can determine the location and the severity of the nerve compression.
Nonsurgical Treatment
A usual treatment option for an ulnar nerve compression is to use a splint on the elbow. The will prevent the patient from bending their elbow and reduce irritation by giving the elbow a rest from the bending motion. Splinting the elbow is uncomfortable and inconvenienent, so this type of treatment is difficult. Surgery is a treatment option if the compression of the nerve is severe enough.
Decompression Surgery
The most common surgery performed for ulnar nerve compression at the elbow is called decompression with anterior transposition. This procedure removes the nerve from its compressive bed and puts into a position that is more suitable. The nerve is effectively lengthen by transferring the nerve anteriorly and decreases the tension during flexion.
Preoperative and Postoperative Details
Before surgery, a patient must undergo tests to prepare for the ulnar nerve compression procedure. Common tests are blood work, chest radiography, and a careful clinical examination. The doctor will need to know of any type of disorders the patient may have. These types of disorders include: history of blood clots in the legs, bleeding problems, allergies, and/or high blood pressure. The basic surgical preparation of the affected extremity from the fingers to neck is indicated. If necessary, a tourniquet application follows.
After surgery, a doctor may prescribe physical therapy to help the patient recover from the ulnar nerve decompression surgery. Movement is encouraged immediately after surgery is performed. The physical therapy helps the patient to regain strength and motion in the arm. Usually, therapy is required for a minimum of three months.
Later the splint is removed and the passive exercise schedule begins. During the passive exercises, no movement that causes the muscle movement besides moving the elbow. The active physical therapy phase starts six weeks after surgery. This phase involves both muscle and bone strengthening exercises.
References
NYU Medical Center: Ulnar Nerve Compression at the Elbow - https://www.med.nyu.edu/neurosurgery/pns/conditions/compressions/neck/ulnar_elbow.html
Precision Neurosurgery: Ulnar Nerve Decompression Surgery - https://www.precisionneurosurgery.com.au/html/surgical_ulnar.htm