Ulnar Nerve Palsy

Ulnar Nerve Palsy

The symptoms of ulnar paralysis differ between individuals depending on the cause of the disease. With early, expert therapy, regression of paralysis is possible in various cases.

What is ulnar nerve palsy?

Ulnar nerve palsy (also known in medicine as ulnar nerve palsy ) is damage that affects the ulnar nerve (a nerve in the brachial plexus). Since the ulnar nerve supplies various muscles in the arm and hand areas, ulnar nerve paralysis usually manifests itself in functional failures of the corresponding muscles. For what does the abbreviation macd stand for, please visit usvsukenglish.com.

Symptoms of ulnar nerve palsy differ depending on the location of the corresponding nerve damage. A common consequence of ulnar nerve palsy is the development of what is known as a clawed or clawed hand ; This manifests itself in the affected person as a spread thumb and a metacarpophalangeal joint that remains stretched even when the fingers are bent.

Other possible symptoms of ulnar nerve palsy include numbness in the little finger and the ball of the little finger. In humans, ulnar nerve palsy is the most common damage to nerves that run outside the brain and spinal cord.

Causes

Various causes can hide behind an ulnar nerve palsy ; Especially with lesions of the ulnar nerve that occur on the upper arm, the paralysis is often due to trauma (external impact).

Fractures ( broken bones ) in the arm area can also cause ulnar paralysis. In some cases, ulnar nerve palsy occurs as a result of surgical repair of injuries to the elbow. Especially in the elbow area, long-term pressure on the ulnar nerve can promote ulnar nerve palsy; such a pressure load can occur, for example, in the context of professional activities in which there is frequent support on the elbows.

Cycling can also put pressure on the ulnar nerve; for example by using triathlon handlebars. Last but not least, when people are bedridden, it is not uncommon for people to suffer from ulnar paralysis due to pressure.

Symptoms, Ailments & Signs

Complaints mainly appear in the form of muscle paralysis and the loss of motor skills. These relate to the elbow and wrist. The so-called clawed hand is typical. This is what physicians call the condition in which the metatarsophalangeal joints are hyperextended and the end joints are slightly bent.

Many patients complain that they can no longer move their little and ring fingers. The thumb usually remains spread out. As a result, the wrist can only be used to a limited extent. Sometimes other muscle groups can compensate for the neuronal limitations, which is why those affected are not always aware of a disease. It is not uncommon for an elbow dislocation to occur as a consequence.

Ulnar paralysis is not only characterized by a recognizable malposition. Those affected also regularly report a feeling of numbness. The sensation on the fingers is significantly reduced. The loss of function of the muscles has a clear impact on everyday life. Simple activities, such as writing or using electronic devices, are only possible with difficulty.

Sick people may need help with small tasks. If the neuronal disease is not treated in time, it can become permanent. The functionality of a hand is then usually clearly impaired.

Diagnosis & History

The diagnosis of ulnar nerve palsy usually begins with a patient consultation, during which the doctor treating you asks about the patient’s medical history and individual symptoms.

In a subsequent neurological examination, various so-called ulnar nerve function tests can provide information about an existing ulnar nerve paralysis; for example, the ability to flex the hand and fingers against various resistances is tested. The nerve conduction velocity of the ulnar nerve can be determined within the framework of a so-called electromyography.

Finally, it can be ruled out that the functional impairments of a patient are due to a problem other than that of the ulnar paralysis. The course of an ulnar paralysis depends, among other things, on its cause and the corresponding treatment steps. With appropriate therapy, for example, ulnar nerve paralysis due to pressure can often regress.

Complications

Ulnar nerve palsy causes serious symptoms and complications. These have a very negative effect on the quality of life of those affected and can significantly reduce it. Many people affected by ulnar paralysis are dependent on the help of other people in their everyday life and can no longer easily do many everyday things.

The patients suffer from severe loss of motor and cognitive abilities. This also leads to restricted mobility and severe limitations in everyday life. Numbness and other sensory disturbances appear in the fingers. The hand itself can also no longer be moved, so that a clawed hand is formed. Elbow dislocation can also occur.

Especially in children, ulnar nerve paralysis can lead to severe limitations and delays in development, so that complaints and complications can also occur in adulthood. The treatment of ulnar nerve palsy always depends on the underlying disease.

No prediction can be given about the course of the disease. Those affected may need surgical interventions to alleviate the symptoms. In most cases, the life expectancy of the patient is not negatively affected by the ulnar paralysis.

When should you go to the doctor?

In the case of ulnar paralysis, the person concerned always needs to see a doctor. This disease cannot heal itself, so an examination and subsequent treatment by a doctor must always be carried out. The sooner a doctor is consulted, the better the further progression of the disease. As soon as the first symptoms and signs appear, the person concerned should consult a doctor. A doctor should be contacted if the patient suffers from severe paralysis in the muscles.

The muscles in the hands are particularly affected, so that the everyday life of the person affected is restricted by the ulnar nerve paralysis. Furthermore, severe pain in the hands can indicate this disease and should also be examined by a doctor. Numbness in the hands can also indicate ulnar paralysis and must be examined by a doctor. The disease can be diagnosed by a general practitioner or by an orthopedist. Further treatment is then carried out by a specialist.

Treatment & Therapy

The therapy of ulnar paralysis depends on factors such as the causes of the paralysis and the individual symptoms of a patient.

In principle, both conservative (non-surgical) and surgical procedures can be used to treat ulnar nerve paralysis. In the context of ulnar paralysis caused by pressure, a conservative treatment method consists, for example, in relieving and padding the affected arm. During the night, the arm affected by ulnar nerve palsy can also be fitted with a splint to prevent corresponding bending movements.

If pressure-induced ulnar paralysis cannot be successfully treated conservatively, the attending physician often considers surgical intervention. Paralysis of the ulnar nerve due to injuries in the elbow area is also often treated surgically.

The ulnar nerve can, for example, be relocated as part of a corresponding operation. A so-called neurolysis is also possible for the surgical treatment of ulnar paralysis: Any constrictions in the ulnar nerve (such as adhesions from scar tissue) are removed in order to relieve the nerve. Surgical measures to treat ulnar nerve paralysis usually require subsequent immobilization of the affected arm for several weeks.

Prevention

Ulnar nerve paralysis due to long-term pressure can be prevented, for example, by protecting the arm; as far as possible, this can be done in the context of occupational and/or sport-related pressure on the arm, for example through the use of appropriate padding. Trauma that can lead to ulnar paralysis can only be prevented to a limited extent.

Aftercare

If the ulnar paralysis was treated surgically, in most cases the affected upper arm is temporarily immobilized with a cast. This procedure gives the extensive and deep wound the opportunity to regenerate. Complete immobilisation of the arm in a cast is only required if the ulnar nerve has undergone open surgery.

If, on the other hand, the surgical procedure was carried out minimally invasively with an endoscope, the entire arm receives a pressure bandage after the operation. The patient is allowed to move his elbow gently. The skin staples or skin sutures applied during an operation can be removed again after about ten to 14 days. However, the prerequisite for this is smooth healing of the wound.

A small drain is often placed at the end of the procedure. It ensures that the blood and wound fluid drain off unhindered. The drainage can be removed after one to three days. Immobilization of the affected arm usually lasts two to three weeks. This is followed by physiotherapy, during which the arm is reaccustomed to normal loads over a period of several weeks.

However, care should be taken with the physiotherapy exercises, because if the procedure is too rapid, there is a risk of swelling and pain. This can even jeopardize the outcome of the operation. It is also important to avoid mechanical stress and excessive pressure.

You can do that yourself

Depending on the cause and therapy, various self-help measures are available to promote the healing of ulnar nerve paralysis. Conservative therapy can be supported at home with gentle exercise and good care of the affected limbs.

If a splint was placed, it must be worn according to the doctor’s instructions. It is best for patients to speak to a physical therapist about exercises that can be performed at home. The diet should be adjusted and a particularly large number of minerals and vitamins should be given during the illness. In addition, general measures such as sufficient bed rest and the avoidance of stress apply. The affected hand may only gradually be used again. Surgical treatment can be supported by taking good care of the scar. No further stress should be placed on the affected hand to prevent the scar from opening and paralysis or injury reoccurring.

Affected people should take it easy for at least four to six weeks. Strenuous physical work must not be carried out during this period. As a rule, the health insurance company covers the costs of the inability to work. If ulnar nerve paralysis is suspected, the insurance company should be involved at an early stage.

Ulnar Nerve Palsy