| Neuropathy
simply refers to an injured nerve. The most common medical
(i.e. non-surgical) neuropathy are those seen in Diabetes,
The most common surgical neuropathy is the compressive neuropathy
of the Median Nerve as seen in Carpal
tunnel Syndrome. Ulnar Neuropathy most frequently occurs
at that point where the Ulnar Nerve passes through the Olecranon
Notch of the elbow. But the Ulnar Nerve can also get compressed
in the wrist as it Passes through Guyon's Canal.
We will focus this section on the most common form of Ulnar Neuropathy
known as Tardy Ulnar Neuropathy.
I.
Anatomy:
Look at your right arm with your Palm facing up. Feel the
bone on the inside of your elbow. The Ulnar N. hooks under
this portion of your elbow. You can feel the groove the nerve
lays in. This in fact, is your "funny bone."
If you gently tap with your finger along this groove you can often
get an electrical sensation. this electrical sensation is
generally abnormal and is not normally present in healthy nerves.
If you have a mild twinge, it is indicative of early compression
of your Ulnar nerve. An exquisite or prominent electrical
twinge (known as a Positive Tinel's Sign) is
characteristic of significant nerve compression.
II.
Signs & Symptoms:
Most people with Tardy Ulnar Neuropathy will have varying degrees
of numbness or "pins & needles" sensation from their
elbow down into and/or only in the little and ring fingers of
the hand. This can be quite painful, but most commonly is
only annoying. The inability to spread ones fingers (as
if playing the piano) is the most common form of muscle weakness
seen in Ulnar compression. This can also be associated with
atrophy (shrinkage or withering) of the interosseous muscles of
the hand. Are the the muscles on the top of your hand shrunken
so that the tends are very prominent? Compare both hands.
The tendons on your hand should be seen, but only mildly grooved
between.
III.
Indications for Surgery:
The most common indication is pain. Most people can easily
cope with mild weakness. Significant weakness which interferes
with hand function is the second most commonly seen reason to
consider surgery.
IV.
Surgery:
The surgical procedure of choice is referred to as an Ulnar Transposition.
As constant stretching and compression of the nerve in the Olecranon
notch is the culprit, simply moving the nerve to the topside of
the elbow, is often sufficient in stopping pain. This transposing
of the nerve will often stop further muscle wasting as well, but
any atrophy present in the hand, is generally irreversible.
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