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Palmar wrist pain caused by ulnar nerve entrapment in the flexor carpi ulnaris tendon
1Division of Plastic and Reconstructive Surgery, Southern Illinois University School of Medicine, Springfield 62708.
A 38-year-old female nurse was seen initially with several years' history of recurring intermittent ulnar wrist pain and paresthesias. The pain was aggravated by specific tasks using her hands, such as typing. Splinting and two steroid injections into the area gave only temporary relief. Surgical exploration revealed a segment of the ulnar nerve composing approximately 15% of its volume to split from the main trunk of the ulnar nerve, perforate the flexor carpi ulnaris tendon, and then rejoin the ulnar nerve. The nerve branch was extracted from the flexor carpi ulnaris by dividing approximately 15% to 20% of the tendon, allowing the nerve to be removed from the perforation, and anatomically relocated. The patient resumed her normal activities and has had no further discomfort in her wrist.
A 38-year-old female nurse was seen initially with several years' history of recurring intermittent ulnar wrist pain and paresthesias. The pain was aggravated by specific tasks using her hands, such as typing. Splinting and two steroid injections into the area gave only temporary relief. Surgical exploration revealed a segment of the ulnar nerve composing approximately 15% of its volume to split from the main trunk of the ulnar nerve, perforate the flexor carpi ulnaris tendon, and then rejoin the ulnar nerve. The nerve branch was extracted from the flexor carpi ulnaris by dividing approximately 15% to 20% of the tendon, allowing the nerve to be removed from the perforation, and anatomically relocated. The patient resumed her normal activities and has had no further discomfort in her wrist.