Lesion of the deep palmar branch of the ulnar nerve: causes and clinical outcome.

AIM OF THE STUDY

We aim to describe the clinical and neurophysiological characteristics of a group of patients with a clinical diagnosis of deep palmar branch lesion of the ulnar nerve. We report the clinical and neurophysiological outcome.

POPULATION AND METHOD

Eleven patients (six males, mean age: 52 years) were included prospectively. Neurophysiological studies were performed in all patients at diagnosis and longitudinally in five.

RESULTS

Occupational trauma was the cause of the nerve lesion in seven patients, neuritis was diagnosed in one and an idiopathic lesion was the final diagnosis in two. In 10 patients, conservative management with interruption of repetitive trauma led to a progressive full recovery. Hand weakness was progressive in one patient who underwent surgical intervention with a diagnosis of ganglion compression, whose removal caused gradual improvement. Neurophysiological studies confirmed severe deep branch lesion, but in four a mild proximal lesion of the ulnar nerve at the wrist was identified. Follow-up neurophysiological studies confirmed the rapid resolution of the lesion.

CONCLUSION

Conservative management should be the first option in patients with deep palmar branch lesion of the ulnar nerve, in particular in patients with a work-related lesion. Electromyography has a central role in diagnosis.