The incidence of ulnar nerve subluxation in patients with ulnar neuropathy at the elbow and healthy control: A clinical, electrodiagnostic, and ultrasonographic study

Abstract

Background: Ulnar neuropathy at the elbow is a common presenting disorder in neuromuscular medicine. Patients suffer from paresthesia in the 4/5 finger, pain at the elbow, and weakness and atrophy in advanced cases. Objective: This study aimed to find the incidence of ulnar nerve subluxation in patients with ulnar neuropathy at the elbow. Materials and Methods: This is a case-control study conducted in Al-Sadiq teaching hospital at the period of January 2018–August 2022. It included 84 patients diagnosed with ulnar neuropathy at the elbow by history, clinical examination and electrodiagnostic testing. All patients and control undergo ultrasonographic examination by high-resolution ultrasound looking for ulnar nerve cross-sectional area at 3 points: (1) 7 cm proximal to medial epicondyle, (2) at the medial epicondyle, and (3) at the cubital tunnel 2-3 cm distal to medial epicondyle. Also, dynamic ultrasonographic examination were done looking for subluxation of ulnar nerve behind medial epicondyle during elbow flexion. If ulnar nerve move on the top of medial epicondyle it is considered partial and when it dislocates anteriorly beyond the tip of medial epicondyle it is considered complete subluxation.

Keywords

• dynamic ultrasound
• ulnar nerve subluxation
• ulnar neuropathy at the elbow