Ulna Nerve Compression Caused by a Tortuous Ulnar Artery

Lee,  Young Sang; Song,  Woo Suk; Choi,  Joon Cheol; Kim,  Woo Sung; Noh,  Hyoun Min; Kim,  Wan Seok; Kim,  Hak Soo

Journal of the Korean Society for Surgery of the Hand 2009;14(4):250-254.
Published online December 1, 2009.

Young Sang Lee, Woo Suk Song, Joon Cheol Choi, Woo Sung Kim, Hyoun Min Noh, Wan Seok Kim, Hak Soo Kim

Department of Orthopedic Surgery, BunDang Jaesang General Hospital, Seongnam, Korea. swoosuk@yahoo.co.kr

Abstract

Purpose
This case report presents ulnar nerve compression which associated with variant distribution of ulnar artery at the proximal site of the wrist. MATERIALS AND METHODS: Based on the patient's symptoms, we could assume a neuropathy resulting from the compression of the ulnar nerve. The magnetic resonance imaging (MRI) was used to evaluate the anatomical abnormality of the ulnar artery at the site of compression, and the elecromyogram (EMG) and Nerve conduction velocity (NCV) were also performed to confirm the overall abnormality of the ulnar nerve.

Results
The tortuous ulnar artery of the lesion which was in the same course as that of ulnar nerve surrounded by sheath seemed to be compressed. Such finding was resolved 5 minutes after taking off tourniquet during adhesiolysis. Along with the improvement in the symptoms of paresthesia and the numbness of the patient a day after the surgery, the atrophy of the muscle and the weakness of the affected lesion were also slightly improved 6 months after the adhesiolysis. The decrease in abnormal spontaneous activity of the ulnar nerve was observed in both EMG and NCV, performed after the 6 month of the surgery.

Conclusion
Among the patients manifesting significant symptoms of neuropathy arising from ulnar nerve compression, the tortuous ulnar artery as the source of entrapment of ulnar nerve was observed. Six months after the adhesiolysis of the sheath, the overall improvement of clinical symptoms was remarkable.