Brief Outline of Ulnar Tunnel Syndrome

One of three major nerves responsible for motor function and sensation in the hand, the ulnar nerve runs along the inside of the forearm, reaching down to the heel of the hand. In the hand, the ulnar nerve radiates across the palm and into the little finger and ring finger. Pressure on the ulnar nerve can result in pain, loss of sensation and muscle weakness in the hand.

Anatomy and physiology

The humerus of the upper arm has three bony points, frequently associated with repetitive strain injuries. Two of these bony points are involved in ulnar tunnel syndrome, the olecranon and the medial epicondyle in the elbow. The space between these bony protrusions is known as the ulnar tunnel. The ulnar nerve, which acts on the muscle that pulls the thumb toward the palm of the hand, also controls small intrinsic muscles of the hand. It passes through the cubital or ulnar tunnel at the elbow, running down the forearm and into the hand. It is one of the three major nerves in the arm, the others being the radial and median nerves.

Ulnar Nerve Neuritis

 

Cause of Ulnar Tunnel Syndrome

Overuse of muscles and tendons of the forearm, especially in golf, and sports involving throwing. Abnormal growth in the wrist, such as cyst. Sudden trauma to the ulnar nerve within the ulnar tunnel.

Sign and symptoms

Weakness and increasing numbness on the little finger side of the hand. Difficulty grasping and holding objects. Tingling along the outer forearm, especially when the elbow is bent.

Treatment

  • Cease the activity which is causing pressure on the ulnar nerve, and avoid keeping the elbow in a bent position.
  • Injection.
  • Physiotherapy.
  • Surgery if all conservative treatment fails.

Rehabilitation and prevention

In the case of ulnar tunnel syndrome due to an abnormal growth such as a cyst, surgery may be required to remove it. Where repetitive stress or exercise have led to ulnar nerve inflammation, non-surgical physical therapy, including strengthening exercises will often yield improvement in 4-6 weeks.

Long-term Prognosis

In cases where ulnar tunnel syndrome receives prompt and appropriate attention, the prognosis for full recovery is good. Nerve damage and deficit can result however, should the condition be allowed to persist without care.

Call (+65) 6471 2674 (24 Hour) to fix an appointment to treat Ulnar Tunnel Syndrome today.

Brief Outline of Wrist and Forearm Fracture

Should an person fall on an outstretched wrist, a break or fracture of the wrist or bones of the forearm may result. Activities vulnerable to such injury include running, cycling, skateboarding, rollerblading and other activities in which an outstretched hand may be used to break a fall.

Anatomy and physiology

The wrist consists of a series of radio-carpal and intercarpal articulations. However, most wrist movement occurs at the radio-carpal joint, an ellipsoid joint. The distal surface of the radius and articular disc articulate with the proximal row of carpals: the scaphoidlunate, and triquestral (triquetrum). Movements are in combination with the intercarpal joints. The intercarpal joints are a series of plane joints, which have articulations between the two carpal row (midcarpal joint), plus articulations between each bone of the proximal carpal row and of the distal carpal row. The distal radio-ulnar joint is immediately adjacent to the radio-carpal joint. A cartilaginous disc separates the distal ulna and radius from the lunate and triquetral bones. Wrist fractures are breaks in one or more of these bones. The two most common wrist fractures are Colles’ fracture, which occurs near the end of the radius, and scaphoid fracture, which involves the scaphoid or navicular, a small bone located on the thumb-side of the wrist that joins the radius.

Wrist Anatomy Bones

 

Cause of Wrist Fracture

  • A fall onto an outstretched wrist.
  • A blow to the wrist.
  • Extreme twisting of the wrist.

Signs and symptoms

Deformity of the wrist. Pain and swelling. Limited motion in the thumb or wrist.

Wrist Fracture

Complications if left unattended

Wrist fractures often fuse naturally, though complications may arise in the untreated fracture leading to limitations of wrist movement and forearm rotation, pronation, and supination. Osteoarthritis may also arise following untreated fractures. Untreated or misdiagnosed scaphoid fractures run the risk of non-union or malunion of fractured bone segments.

Treatment

  • K-Wiring
  • Plates and screws fixation
  • Fibreglass cast

Rehabilitation and prevention

Immobilisation with a rigid cast is generally required for such fractures to properly heal, with x-ray follow-ups to analyse improvement. Where surgery is required, wires or screws may be employed to fuse fractured segments.

Call (+65) 6471 2674 (24 Hour) to fix an appointment with our orthopaedic surgeon regarding wrist and forearm fracture today.