Ulnar nerve entrapment neuropathy in the forearm

Area of Science:

• Neurology
• Vascular Surgery
• Hand Surgery

Background:

• Ulnar nerve entrapment can cause progressive motor and sensory deficits in the hand.
• Compression of the ulnar nerve typically occurs at the elbow or wrist.
• Identifying the precise site of nerve compression is crucial for effective treatment.

Observation:

• A 74-year-old male presented with progressive weakness in the right hand's fourth and fifth digits, impacting grip and writing.
• Symptoms included lancinating pain triggered by pressure on the ulnar forearm.
• Nerve conduction studies showed a complete electrical block 5 cm proximal to the wrist crease.

Findings:

• Surgical exploration revealed two fibrovascular bands entrapping the ulnar nerve between the ulnar artery and the flexor carpi ulnaris.
• These bands caused significant grooving of the ulnar nerve.
• A complete electrical block was identified at the site of entrapment.

Implications:

• Surgical release of the entrapping fibrovascular bands successfully resolved the ulnar nerve compression.
• The patient experienced complete pain relief and full neurologic recovery within six months post-surgery.
• This case highlights the importance of considering unusual sites of ulnar nerve entrapment, even in the forearm, and the efficacy of surgical decompression.