Avoiding and Managing Ulnar Nerve Injuries

Elbow injuries can cause nerve damage to the ulnar nerve. The ulnar nerve is located on the inside of the elbow. The ulnar nerve can be injured easily.
This is because it rests in a shallow groove close to the surface of the skin,

In this report, surgeons from Massachusetts General Hospital (MGH) in Boston review current concepts in the treatment of the ulnar nerve in elbow injuries. Forearm muscle atrophy and elbow weakness can occur as a result of acute injury or nerve palsy. Numbness, tingling, and other sensory changes are also commonly reported. This condition is called ulnar nerve neuropathy.

The authors review the ulnar nerve anatomy and discuss what happens when the nerve is injured. Swelling, scarring, and thickening of the fibrous tunnel around the nerve can occur right away after injury or much later. Pulling or traction on the nerve can happen during surgery to treat an elbow injury.

Even the most gentle handling of the nerve can result in problems. Sometimes symptoms don't occur for many months after the injury. Causes of delayed nerve palsy include the development of bone spurs in the elbow area and poor healing of a bone fracture.

Recovery from ulnar nerve injury is often a long process. Return to normal doesn't always happen. Patients with diabetes are even more likely to have delayed or incomplete healing. Left alone, these injuries often get worse.

Surgery may be the only way to relieve symptoms. The nerve may be transposed (moved) away from the pressure area. Or bone around the nerve may be shaved off or removed.

Prevention is the key to ulnar nerve neuropathies. Surgeons are advised to identify and protect the nerve whenever surgery is done to the elbow. Certain conditions are more likely than others to cause ulnar nerve damage. Surgeons are advised to be cautious when treating elbow dislocation with fracture.

References: Robert Shin, MD, and David Ring, MD. The Ulnar Nerve in Elbow Trauma. In Journal of Bone and Joint Surgery. May 2007. Vol. 89. No. 5. Pp. 1108-1116.