Skip to main content

Management of Chronic Ulnar Neuropathy

  • Chapter
  • First Online:
Cubital Tunnel Syndrome
  • 726 Accesses

Abstract

Management of chronic ulnar neuropathy remains a complex problem without simple solutions. Any surgeon caring for patients suffering from chronic ulnar neuropathy must be able to recognize the impairment patterns, accurately assess the degree of nerve dysfunction, and assess the recovery potential before formulating and implementing a treatment plan. This chapter provides an overview of the management of chronic ulnar neuropathy, beginning with patient evaluation and then discussing some of the more common clinical scenarios and available treatments.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Woo A, Bakri K, Moran SL. Management of ulnar nerve injuries. J Hand Surg Am. 2015;40(1):173–81.

    Article  PubMed  Google Scholar 

  2. Dawson DM. Entrapment neuropathies of the upper extremities. N Engl J Med. 1993;329(27):2013–8.

    Article  CAS  PubMed  Google Scholar 

  3. Kennedy JM, Zochodne DW. Impaired peripheral nerve regeneration in diabetes mellitus. J Peripher Nerv Syst. 2005;10(2):144–57.

    Article  CAS  PubMed  Google Scholar 

  4. Rinker B, et al. The effect of cigarette smoking on functional recovery following peripheral nerve ischemia/reperfusion injury. Microsurgery. 2011;31(1):59–65.

    Article  PubMed  Google Scholar 

  5. Tung TH, Mackinnon SE. Nerve transfers: indications, techniques, and outcomes. J Hand Surg Am. 2010;35(2):332–41.

    Article  PubMed  Google Scholar 

  6. Verdú E, et al. Influence of aging on peripheral nerve function and regeneration. J Peripher Nerv Syst. 2000;5(4):191–208.

    Article  PubMed  Google Scholar 

  7. Pannell WC, et al. Predictors of nerve injury after gunshot wounds to the upper extremity. Hand. 2017;12(5):501–6.

    Article  PubMed  Google Scholar 

  8. Campbell WW. Evaluation and management of peripheral nerve injury. Clin Neurophysiol. 2008;119(9):1951–65.

    Article  PubMed  Google Scholar 

  9. Lad SP, et al. Trends in median, ulnar, radial, and brachioplexus nerve injuries in the United States. Neurosurgery. 2010;66(5):953–60.

    Article  PubMed  Google Scholar 

  10. Brown P. Zancolli capsulorrhaphy for ulnar claw hand-appraisal of forty-four cases. Plast Reconstr Surg. 1971;48(5):512.

    Article  Google Scholar 

  11. Leddy JP, et al. Capsulodesis and pulley advancement for the correction of claw-finger deformity. JBJS. 1972;54(7):1465–71.

    Article  CAS  Google Scholar 

  12. Parkes A. Paralytic claw fingers—a graft tenodesis operation. Hand. 1973;5(3):192–9.

    Article  CAS  PubMed  Google Scholar 

  13. Riordan DC. Tendon transplantations in median-nerve and ulnar-nerve paralysis. JBJS. 1953;35(2):312–86.

    Article  Google Scholar 

  14. Zancolli EA. Claw-hand caused by paralysis of the intrinsic muscles: a simple surgical procedure for its correction. JBJS. 1957;39(5):1076–80.

    Article  Google Scholar 

  15. Brand PW. Tendon grafting: illustrated by a new operation for intrinsic paralysis of the fingers. J Bone Joint Surg Br Vol. 1961;43(3):444–53.

    Article  Google Scholar 

  16. Bunnell S. Surgery of the intrinsic muscles of the hand other than those producing opposition of the thumb. JBJS. 1942;24(1):1–31.

    Google Scholar 

  17. Burkhalter WE, Strait JL. Metacarpophalangeal flexor replacement for intrinsic-muscle paralysis. JBJS. 1973;55(8):1667–76.

    Article  CAS  Google Scholar 

  18. Littler JW. Tendon transfers and arthrodeses in combined median and ulnar nerve paralysis. JBJS. 1949;31(2):225–34.

    Article  Google Scholar 

  19. Schwarz R, Brandsma J, Giurintano D. A review of the biomechanics of intrinsic replacement in ulnar palsy. J Hand Surg Eur Vol. 2010;35(2):94–102.

    Article  CAS  PubMed  Google Scholar 

  20. Stiles HJ, Forrester-Brown MF. Treatment of injuries of the peripheral spinal nerves. London: H. Frowde/Hodder & Stoughton; 1922.

    Google Scholar 

  21. Brown P. Restoration for pinch in ulnar intrinsic palsy. Orthop Clin North Am. 1974;5:323–42.

    Google Scholar 

  22. Edgerton MT, Brand PW. Restoration of abduction and adduction to the unstable thumb in median and ulnar paralysis. Plast Reconstr Surg. 1965;36(2):150–64.

    Article  CAS  PubMed  Google Scholar 

  23. Smith RJ. Extensor carpi radialis brevis tendon transfer for thumb adduction—a study of power pinch. J Hand Surg Am. 1983;8(1):4–15.

    Article  CAS  PubMed  Google Scholar 

  24. Waters R, et al. Brachioradialis to flexor pollicis longus tendon transfer for active lateral pinch in the tetraplegic. J Hand Surg Am. 1985;10(3):385–91.

    Article  CAS  PubMed  Google Scholar 

  25. Mohammed KD, et al. Upper-limb surgery for tetraplegia. J Bone Joint Surg. 1992;74(6):873–9.

    Article  CAS  Google Scholar 

  26. Robinson D, Aghasi M, Halperin N. Restoration of pinch in ulnar nerve palsy by transfer of split extensor digiti minimi and extensor indicis. J Hand Surg. 1992;17(6):622–4.

    Article  CAS  Google Scholar 

  27. Stocks GW, Cobb T, Lewis RC. Transfer of sensibility in the hand: a new method to restore sensibility in ulnar nerve palsy with use of microsurgical digital nerve translocation. J Hand Surg. 1991;16(2):219–26.

    Article  CAS  Google Scholar 

  28. Johnson HA. Dermis graft for post-leprosy muscular wasting in the hand. Plast Reconstr Surg. 1961;27(6):624–6.

    Article  CAS  Google Scholar 

  29. Coleman SR, Carraway JH. Hand rejuvenation with structural fat grafting. Plast Reconstr Surg. 2002;110(7):1731–44.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Robert J. Goitz .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Sivak, W.N., Goitz, R.J. (2019). Management of Chronic Ulnar Neuropathy. In: Fowler, J. (eds) Cubital Tunnel Syndrome. Springer, Cham. https://doi.org/10.1007/978-3-030-14171-4_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-14171-4_15

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-14170-7

  • Online ISBN: 978-3-030-14171-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics