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Related Experiment Video

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The "hierarchical" Scratch Collapse Test for identifying multilevel ulnar nerve compression.

Kristen M Davidge1, Gil Gontre1, David Tang1

  • 1Division of Plastic Surgery, Washington University of St. Louis, 660 S. Euclid Avenue, Campus Box 8,238, St. Louis, MO 63110 USA.

Hand (New York, N.Y.)
|September 3, 2015
PubMed
Summary
This summary is machine-generated.

The hierarchical Scratch Collapse Test (SCT) effectively identifies primary and secondary ulnar nerve compression sites in cubital tunnel syndrome patients. This method aids in diagnosing multilevel nerve entrapment, supporting existing hypotheses.

Keywords:
Cubital tunnel syndromeMultilevel nerve compressionScratch collapse test

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Area of Science:

  • Orthopedics
  • Neurology
  • Physical Examination Techniques

Background:

  • The Scratch Collapse Test (SCT) is a clinical tool for evaluating ulnar nerve compression.
  • Cubital tunnel syndrome is a common condition involving ulnar nerve entrapment at the elbow.

Purpose of the Study:

  • To introduce and evaluate the hierarchical SCT for identifying multilevel nerve compression in cubital tunnel syndrome.
  • To determine the primary and secondary sites of ulnar nerve entrapment.

Main Methods:

  • A prospective cohort study of 25 patients with primary cubital tunnel syndrome.
  • Sequential application of SCT at five potential compression sites, with anesthetic 'freezing out' of positive sites.
  • Recording the order (hierarchy) of compression sites identified.

Main Results:

  • Osborne's band (80%) and cubital tunnel retinaculum (20%) were primary entrapment sites.
  • All patients exhibited secondary compression at the volar antebrachial fascia, Guyon's canal, and arcade of Struthers, in that order.
  • The hierarchical SCT successfully identified both primary and secondary compression points.

Conclusions:

  • The hierarchical SCT is valuable for localizing primary ulnar nerve compression in cubital tunnel syndrome.
  • The test detects secondary compression sites, supporting the double crush and multilevel nerve compression hypotheses.
  • This refined physical examination tool enhances diagnostic accuracy for complex ulnar nerve entrapment.