What is ulnar nerve entrapment?
Ulnar nerve entrapment is the second most common nerve entrapment syndrome Although the nerve can be compressed at various points along its course in the arm and forearm, it is much more common for this to occur at the elbow, in an area called the ‘cubital tunnel,’ where it lies very superficially beneath the skin and passes through the epitrochleo-olecranon canal. Casi todos hemos sentido alguna vez la compresión del nervio en ese lugar, casi siempre por una mala posición al dormir. The ulnar nerve controls part of the sensation and movements of the hand, particularly of the ring and little fingers. Compression can cause tingling and weakness in these fingers, along with difficulty performing fine movements. In more advanced cases, it can lead to muscle atrophy and a claw-like deformity.
How is it diagnosed?
The diagnosis is made through a detailed physical examination, looking for symptoms such as numbness in the mentioned fingers or loss of strength in the hand. There are specific tests and provocative maneuvers to detect ulnar nerve dysfunction. We rely on nerve conduction studies and electromyography to locate the compression and assess its severity. It can occasionally be complemented with imaging studies such as ultrasound or MRI.
What is the treatment for ulnar nerve entrapment?
Initial treatment in cases of mild or moderate compression includes activity modification and the use of splints, as well as physical therapy. If there is no symptomatic improvement or if the compression is disabling, surgery is recommended. This may consist of releasing the nerve at the elbow (simple decompression), or repositioning it using forearm muscle structures (anterior transposition). The goal of the procedure is to relieve pressure on the nerve and to preserve or restore its function. The procedure is also performed on an outpatient basis, and the outcomes are generally favorable.
