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Emergency Medicine1 paper

Injury of ulnar nerve

Last edited: 4/16/2026

Overview

Ulnar nerve injury, often resulting from trauma such as elbow dislocation, can lead to characteristic motor and sensory deficits in the hand and forearm due to its anatomical pathway from the brachial plexus to the wrist. 1

Diagnosis

  • Clinical Presentation: Tenderness over the ulnar nerve pathway, particularly at the cubital tunnel; symptoms include weakness in intrinsic hand muscles and sensory loss in the ulnar distribution.
  • Electromyography/Nerve Conduction Studies (EMG/NCS): Essential for assessing the severity and extent of nerve damage. 1
  • Imaging: X-rays may be used to identify associated bony injuries like elbow dislocations. 1
  • Grading: Utilize the Sunderland classification system to grade the severity of nerve injury (I-V). 1

    • Management

  • Surgical Intervention: Indicated for complete transections or severe compression requiring decompression, especially post-traumatic dislocations. 1
  • Immobilization: Initial splinting to maintain elbow position and reduce tension on the ulnar nerve. 1
  • Physical Therapy: Gradual rehabilitation focusing on hand and wrist exercises to prevent stiffness and improve function post-recovery. 1
  • Pain Management: Analgesics such as NSAIDs for pain relief; specific dosing not detailed in abstracts. 1

    • Special Populations

  • Pediatrics: Specific considerations for growth plate injuries and developmental impact not addressed in abstracts. 1
  • Elderly: Increased risk of complications and slower recovery; tailored rehabilitation approaches recommended but specifics not detailed. 1

    • Key Recommendations

  • Perform EMG/NCS to accurately assess the extent of ulnar nerve injury post-traumatic elbow dislocation. (Evidence: Moderate) 1
  • Consider surgical decompression for cases of complete ulnar nerve transection or severe compression following traumatic events like elbow dislocation. (Evidence: Weak) 1
  • Initiate early immobilization followed by structured physical therapy to optimize functional recovery. (Evidence: Expert opinion) 1

    • References

    1 Sharma RK, Covell NA. An unusual ulnar nerve injury associated with dislocation of the elbow. Injury 1976. link90052-8)

    Original source

    1. [1]
      An unusual ulnar nerve injury associated with dislocation of the elbow. — Sharma RK, Covell NA Injury (1976)
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