Ulnar Nerve Entrapment Neuropathies

Ulnar neuropathy is the second most common entrapment neuropathy in the upper extremity after carpal tunnel syndrome. Because of the anatomic positioning of the ulnar nerve, the most common site of entrapment is at the elbow region. Potential compression sites at the elbow are the arcade of Struthers, medial intermuscular septum, retroepicondylar groove, the cubital tunnel (humeroulnar arcade) and flexor-pronator aponeurosis, with the most common sites of entrapment at the cubital tunnel and the retroepicondylar groove. The second most likely location of entrapment is in the Guyon's canal at the wrist. The diagnosis is based on symptoms, physical examination findings and electrodiagnostic studies. Treatment is planned according to the patient's symptoms and severity of disease. Surgical treatment should be considered if there is no response to the conservative treatment and if there is evidence for the presence of progressive paralysis and long-term lesion. In this paper, potential anatomical sites for entrapment of the ulnar nerve, pathophysiology, clinical and electrophysiological diagnosis and conservative treatment of the ulnar nerve entrapment neuropathies are reviewed. Turk J Phys Med Rehab 2010;56:190-5.