Hand Surgery

Sulcus Ulnaris Syndrome, SUS, Ulnaris Compression Syndrome I

Cause / Development

In the elbow joint area, the nervus ulnaris runs in a bone tunnel, which is called the sulcus nervi ulnaris. It is covered by tight tissue. If you run this area into any hard object, you will feel an electrical jolt of pain all the way up into your hand. This is why this is also referred to as the “Musician’s Bone”. At the end of the tunnel pointing away from the body the nervus ulnaris is located between the two protrusions of the wrist bending muscle on the ulnary side. Pressure damages typical for the Sulcus Ulnaris Syndrome (SUS) may be the result of chronic pressure (e.g. supporting the arms while driving a car), fractures, blastomas, an X-dislocation of the elbow or wear and tear.

Symptoms

In the early stages of the disease, patients frequently notice strange sensations in the small and ring finger (at the small finger end). Later, paralysis or weakness of the hand as well as reduced sensations in small and ring finger (at the small finger end) may be present. When tapping on the nervus ulnaris of patients suffering from sulcus ulnaris, a sensation of electrical currents running through them can frequently be triggered. Once the disease has reached a progressive state, the size of the small hand muscles between the middle hand bones can be detected – especially between thumb and index finger. Ultimately, a so-called >claw hand< develops.

Prior to treatment

A neurologist can determine if a compression of the nervus ulnaris in the sulcus ulnaris is present by measuring the "nerve streams" (= ENG / EMG). It is absolutely essential to perform this measurement prior to surgery.  next