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03-OCTOBER-2019 INAS QAYS AL-HADITHY 44 YEARS
LEFT ULNAR NERVE ENTRAPMENT AFTER INJURY TO THE LEFT WRIST WITH FRACTURE AND
MALUNION OF THE STYLOID ULNAR BONE.
Anamnesis
The patient came to the clinic 19-Sptember-2019
complaining of numbness both hand more the left
awakening her during night. Pain both shoulders
more the left for 45 days. She had injury to
the left wrist in March-2019. MRI cervical spine
done 31-July-2019 and right knee were normal.
MRI of the left wrist showing non union of the
styloid left ulna with edema of the area.
On examination: the patient has weak grip and
extension left hand with hypalgesia of the ulnar
distribution and hypotrophy of the interossii
left hand.
Lazy incision over the
projection of the left ulnar nerve at the wrist.
The Guyon's canal opened the the nerve follows
down until the division to superficial and deep
motor branch. The ulnar artery was preserved. A
2 cm incision was done over the styloid process
of the ulnar bone. The part was flail.
Decortication of the pseudojoint. The piece was
fixed using 2.5X25 mm screw. The stages were
confirmed with C-arm. Routine closure of the
wounds. Back-slap was applied.
Smooth postoperative recovery.
She was sent to the ward.
Comments
The left ulnar nerve has post-traumatic
entrapment with neurologic manifestations. Exploration of the
Guyon's canal and release of the deep motor and superficial
sensory branches and fixation of the loose fragment of the
styloid of the ulnar bone were necessary.
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