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Double Crush Ulnar Nerve Palsy with Vascular Compression Causing First Dorsal Interosseous and Adductor Deficit: A
Natalia A Pluta1, Manuela Gaviria1, Braden N Miller2
1Department of Orthopaedic Surgery, Brooke Army Medical Center, Ft. Sam Houston, Texas.
Case:
We present a case of a 30-year-old man with severe ulnar nerve neuropraxia and first dorsal interosseous muscle wasting. Intraoperatively, a large venous plexus compressing the terminal division of the deep motor branch of the ulnar nerve was identified as a contributing factor.
Conclusion:
This is the first documented instance of compression of the terminal branch of the ulnar nerve caused by a venous plexus, resulting in neurapraxia. This rare anatomical variant caused progressive functional impairment and was successfully treated with ligation of vessels distally along with proximal and distal nerve decompression.
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