Ulnar nerve palsy in Paget's disease

Area of Science:

• Orthopedic Surgery
• Neurology
• Bone Diseases

Background:

• Paget's disease of bone is a chronic condition characterized by abnormal bone remodeling.
• Enlargement of the humerus, particularly the medial epicondyle, can occur in advanced Paget's disease.
• Ulnar nerve palsy is a condition affecting the ulnar nerve, often caused by compression or entrapment.

Observation:

• A 73-year-old female patient presented with enlargement of the distal right humerus due to Paget's disease.
• The patient developed symptoms of ulnar nerve palsy.
• This specific association between Paget's disease-induced humeral enlargement and ulnar nerve palsy appears to be previously unreported.

Findings:

• Surgical transposition of the ulnar nerve anterior to the elbow was performed.
• The patient experienced complete relief of ulnar nerve palsy symptoms following the procedure.

Implications:

• This case highlights a potential, previously unrecognized complication of Paget's disease of bone affecting the elbow.
• Anterior ulnar nerve transposition is an effective surgical treatment for ulnar nerve palsy secondary to humeral expansion in Paget's disease.
• Further research may be warranted to understand the prevalence and pathophysiology of this association.