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The European Hand Surgery Center
主頁 / Diseases / Carpal groove of the ulnar nerve

Carpal groove of the ulnar nerve

What is it?

Carpal groove of the ulnar nerve is a set of symptoms caused by the most common chronic compression of the ulnar nerve in the canal ścięgnisto skeletal muscle called the ulnar nerve groove.

Cause

The ulnar nerve is surrounded by a groove part of the bone: the medial epicondyle of the humerus bone and soft tissue consisting of muscles and the tendinous structure of the forearm and arm. The pressure increase in the groove causes a disruption of nerve conduction through the nerve and leads to the patient develops symptoms.
Oppression nerve in the groove can be formed in several ways. Chronic inflammation of the soft tissues running around the elbow joint can cause the overgrowth and increased oppression of the ulnar nerve in the groove by tightening the nerve from the outside.
Pinching a nerve outside the elbow by laying on a hard surface often causes the onset of symptoms in particular where the nerve is not sufficiently isolated from the skin e.g., a layer of fat. Very often the anatomy of this area predisposes to disease symptoms as when the affected is the free movement of the nerve in the groove during flexion and extension of the elbow-then comes to overstretching the nerve and the emergence of symptoms. Sometimes the nerve is too loose and during flexion and extension movements of the elbow rubs against the epicondyle at the constant repetition will also occur on the hands of the symptoms of the disease.

Symptoms

The main symptoms are numbness, tingling fingers on the finger IV and V and kłębiku uninterpretable group of symptoms doctors call parastezjami. Parestezjom very often accompanied by pain and numbness on the fingers. Symptoms occur or worsen with the increase in pressure in the groove, eg. During bending and straightening the elbow (doing the work) or when constantly tightens the ulnar nerve which is in the groove, eg. When talking on the phone.
Due to the fact that the ulnar nerve at hand is responsible for the feeling and movement of his oppression entails the formation of muscle atrophy in his arms. In advanced cases of the disease numbness of fingers - as they say Patients "numb fingers" may remain constant, as well as the muscles disappear inside the hand which reduces the force of the hand-loss items from the hand, reducing the efficiency of his hand, and changing their appearance.

Testing and diagnosis

Information obtained from the patient during a medical visit-interview lekarski- are most important to recognize the disease. Interview concerns of symptoms, the time from when they occur, are severe, activities that may cause them, the profession performed by the patient and concomitant diseases that may affect the appearance of carpal Groove ulnar nerve. It is very important to examine the efficiency and strength of the hand to evaluate the function of the muscles inside the hand. The study area of ​​the groove will initially determine if the nerve is "too tight" or "too loose" in its location.
Some concomitant diseases often cause symptoms of the disease for example. :: Thyroid disease, rheumatic disease, gout, diabetes.
The doctor may also ask the patient was treated as before due to the occurrence of its symptoms. Examine the hand-to perform specific diagnostic tests, and test your nerve conduction and electro-muscular EMG- posed helps confirm the diagnosis and determine the degree of advancement of the disease.
It is also useful to perform some biochemical tests of blood, X-ray / CT / IMR cervical spine X-ray or elbow.

Treatment

Sometimes, symptoms may withdraw spontaneously. Change in working conditions or habits, aggravating the elbow area can also result in a reduction or disappearance of symptoms of the disease. Planting elbow cushions during operation, the use of pinning the elbow in extension at night can lead to a reduction or disappearance of symptoms. The use of physical therapy in some patients may result in resolution of symptoms.
When the severity is high or there is no improvement after treatment of unresectable doctor may suggest perform surgery, which is the release of the ulnar nerve of oppression in the groove when the nerve is "too tight" or the stabilization of the position of the nerves when the nerve is "too loose".
The release of oppression is obtained by the intersection of all oppressive structures outside the ulnar nerve structures, sometimes even performing a partial excision of the medial epicondyle. The nerve can be left in place or be moved out of the groove in the muscle or skin called. Transposition of the nerve.
The stabilization of the position of the nerve is performed by the transposition of the nerve.

After the surgery

After surgery, the symptoms may disappear immediately or several months after surgery. In advanced cases of the disease the patient may experience an improvement in reducing symptoms, but some of the symptoms such as. Numbness in the fingers, muscle atrophy may persist for life. After surgery, the patient may not feel significant improvement in the efficiency of his hand or notice changes in the appearance of the hand.
It happens that some patients may experience an increase in / recurrence of symptoms of the disease which is associated with underlying diseases or occupational or sometimes without giving up to find the cause. In such cases, you may need to perform another surgery. Depending on the type of surgery performed physician recommends further investigation (limitation of motion of the elbow, rehabilitation).
Please note that the final effect of the treatment depends on the degree of development of the disease as well as the good cooperation between the patient and the doctor.

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