Ulnar Nerve

Czech version

Authors: E. Ehler ¹; P. Ridzoň ²
Authors‘ workplace: Neurologická klinika FZS UP a Pardubické krajské nemocnice, a. s. ¹; Neurologické oddělení, Thomayerova nemocnice, Praha ²
Published in: Cesk Slov Neurol N 2017; 80/113(2): 130-141
Category: Minimonography
doi: https://doi.org/10.14735/amcsnn2017130

Overview

Ulnar nerve, together with median nerve, innervates the volar group of forearm muscles, hand and fingers. Ulnar nerve is more important for innervation of muscles and weakness, clumsiness of fingers and hand occure in case of the nerve lesion; ulnar claw hand developes in advanced cases. According to the length of the nerve and to the exposed course in regions of elbow and hand, the nerve is frequently overstretched and damaged. The nerve traumatization occurs only rarely in the axilla and arm regions. The ulnar nerve is very often damaged in the elbow, where the nerve is located in a differently deep ulnar nerve grove and then in the cubital tunnel. The ulnar nerve is protected in the forearm course by a layer of flexor muscles. The nerve appears more superficially at the wrist and in the palm, where the ulnar nerve is exposed to chronic traumatization. An ulnar nerve lesion manifests with characteristic weakness of movements and sensitivity disturbances with respect to localization and severity of the lesion. At present, electrodiagnostic methods are the most useful in the diagnostics of the ulnar nerve lesions but neuroimaging (especially ultrasonography) is increasingly more often indicated. Chronic overburden with a damage of the ulnar nerve in the elbow is the second most frequent occupational mononeuropathy. This is why precise methodology for determination of ulnar nerve lesions in the elbow due to occupational cause was developed. Variable approaches are used for surgical treatment of ulnar nerve lesions in the elbow or in the wrist and hand and the surgery is the appropriate and effective therapy in the majority of cases.

Key words:
ulnar nerve – electrodiagnostic methods – ultrasonography – occupational mononeuropathy

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Sources

1. Ambler Z. Poruchy periferních nervů. Praha: Triton 2013.

2. Stewart JD. Focal peripheral neuropathies. 3rd ed. Philadelphia: Lippincott Williams & Wilkins 2000.

3. Unver Dogan N, Uysal II, Seker M. The communication between ulnar and median nerves in upper limb. Neuroanatomy 2009;8:15–9.

4. Staal A, van Gijn J, Spaans F. Mononeuropathies: examination, diagnosis and treatment. London: W.B. Saunders 1999.

5. Leis AA, Štětkářová I, Wells KJ. Martin-Gruber anastomosis with anomalous superficial radial innervation to ulnar dorsum hand: a pitfall when common variants coexist. Muscle Nerve 2010;41(3):313– 7. doi: 10.1002/ mus.21510.

6. Ehler E, Ambler Z. Mononeuropatie. Praha: Galén 2002:82– 4.

7. Mumenthaler M, Stöhr M, Müller-Vahl H. Läsionen peripherer Nerven und radikuläre Syndrome. 9. Auflage. Stuttgart: Georg Thieme Verlag 2007.

8. Ridzoň P. Útlakové léze loketního nervu profesionálního původu. Neurol Praxi 2014;15(4):260– 2.

9. Ehler E, Ridzoň P, Urban P, et al. Ulnar nerve at the elbow – normative nerve conduction study. J Brachial Plex Peripher Nerve Inj 2013;8(1):2– 7. doi: 10.1186/ 1749-7221-8-2.

10. Ehler E, Ridzoň P, Nakládalová M, et al. Neurofyziologická diagnostika poškození loketního nervu v oblasti lokte. Cesk Slov Neurol N 2014;77/ 110(2):210– 5.

11. Seror P. Electrophysiological pattern of 53 cases of ulnar nerve lesion at the wrist. Clin Neurophys 2013;43(2):95– 103. doi: 10.1016/ j.neucli.2012.11.037.