Anatomical Anomalies Causing Ulnar Neuropathy

Abstract

We begin our report with the case of a 25-year-old woman with a characteristic clinical course of primary ulnar nerve compression syndrome. There had been no symptoms until she suffered a trauma to her left elbow following a sporting accident. Subsequently pain radiating from the elbow joint to the ulnar edge of the forearm and paresthesia over the supply area of the left ulnar nerve appeared. Symptoms were partially dependent on movement in the elbow joint. The neurological investigation proved hypoesthesia, hypoalgesia, and a noticeable weakness of the ulnar nerve dependent muscles. Neurophysiological investigation showed normal findings on ulnar as well as on median nerve. Plain X-rays demonstrated evidence of a processus supratrochlearis (Fig. 1). As conservative therapy had no effect, we performed an operation. The supratrochlear spur, the underlying median nerve, and the ulnar nerve up to the cubital tunnel were exposed (Fig. 2). There was no neuroma or other visible changes on either nerve. Resection of the spur led to constant remission of pain and all sensory and motor deficits.