The ulnar nerve is one of three main nerves in the hand. The ulnar nerve gives power to most of the deep small muscles of the hand (intrinsic muscles), along with a number of larger muscles in the forearm.
Ulnar nerve injuries can be classified as high or low level, depending on where in the arm they are damaged. They can be damaged by direct laceration or compression.
The most common places for compression of the ulnar nerve to occur are the Cubital Tunnel (inside the elbow) or Guyon’s Canal (at the wrist).
When the ulnar nerve is damaged, there is a loss of sensation to the ring and little fingers. There can also be a loss of intrinsic muscle power and, as a result, the hand may develop a claw like posture. In this claw position, the MCP joints are hyperextended and the IP joints are flexed. This is most visible at the ring and little fingers.
Ulnar nerve injuries that don’t require surgical repair or decompression should be positioned in a custom make splint to prevent a fixed claw deformity of the little and ring fingers.
As the ulnar nerve recovers, control of the muscles and strength improves. As this happens, less restrictive splints can be used instead.
Hand therapy can help treat nerve injuries of the upper limb. We can thoroughly assess the nerves that supply the hand, provide custom made splints, and prescribe appropriate exercises as the nerve recovers.
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