Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Cubital tunnel syndromeUlnar tunnel syndrome (UTS)Tardy ulnar nerve palsyMedial neuritis syndromeUlnar nerve entrapment ++ 354.2 Lesion of ulnar nerve354.5 Mononeuritis multiplex955.2 Injury ulnar nerve ++ G56.20 Lesion of ulnar nerve, unspecified upper limb +++ Description ++ Motor and/or sensory changes in the ulnar nerve distribution due to pressure from 3 possible ways.CompressionStretchFrictionPotential entrapment sitesMedial humeral grooveArcade of StruthersMedial intermuscular septumFlexor digitorum profundusFlexor carpi ulnarisJust proximal to or within Guyon’s canalSensory and motor involvement between the abductor digiti minimi and flexor digiti minimi Near hook of hamate, involves motor onlyDistal end of Guyon’s canal, involves sensory only +++ Essentials of Diagnosis ++ Night painSensory changes on volar aspect of digit V and ulnar aspect of digit IVHand clumsiness and/or weaknessSymptom changes with elbow position and/or pressure over the cubital tunnel Reproduction of symptoms during clinical examination +++ General Considerations ++ Need to differentiate from more proximal and distal ulnar nerve compression, thoracic outlet syndrome (TOS), ulnar tunnel, and cervical radiculopathy. Postoperative therapy depends on surgical procedure performed: endoscopic release, in situ decompression, medial epicondylectomy, and anterior transposition. Second-most common nerve compression syndrome in the upper extremity (UE) +++ Demographics ++ Those who work for sustained periods with power tools or on computers +++ Signs and Symptoms ++ Acute or chronic paresthesia in ulnar nerve distribution (digits IV ulnar half and V) dorsally and volarly.Sensory changes, hypo- or hypersensitivity of handNight pain especially with elbow flexion and wrist extensionInability to separate fingersHand clumsinessHand weakness and loss of grip power and dexterityClawing of the hand (less pronounced than with ulnar tunnel syndrome)1Intrinsic muscle atrophy and possible gutteringWartenberg signFroment signBishops deformityPositive elbow flexion testResting abduction of digit V +++ Functional Implications ++ Night pain/poor sleep habitsDifficulty with hand function during ADLs/IADLs due to hand clumsiness and possible loss of strength. +++ Possible Contributing Causes ++ Prolonged pressure on cubital tunnel, particularly with elbow flexion such as working at a computer2Laxity of soft tissue structures that hold ulnar nerve in cubital tunnelBony abnormality of the humuerusShallow ulnar grooveSmall medial condyleTightness of the flexor carpi ulnaris (FCU) with distal FCU inflammationViral infectionGanglion/space occupying lesionUlnar artery thrombosisUlnar-sided wrist fractures or dislocationsAnomalous musclesRepetitive traumaSustained pressure over Guyon’s canal such as resting hypothenar eminence on handlebars while long distance cycling. +++ Differential Diagnosis ++ Thoracic outlet syndrome (TOS)Cervical radiculopathyRadial neuropathyMedian neuropathyCarpal tunnel syndromeProximal ulnar nerve entrapmentDistal ulnar nerve ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.