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压迫性神经病变

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Hand numbness, tingling, or weakness – understanding carpal tunnel, cubital tunnel, and other compression neuropathies.

Updated Jun 2026
一幅手绘插图，展示了一只手，手指有针刺般的麻木感。
正中神经（手掌中心）支配拇指、食指、中指及环指内侧半；尺神经（沿小指侧）支配小指及环指外侧半。腕部或肘部的压迫会表现为这些特定的分布模式。 Kieran Hirpara 4.0

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

您的感受

您可能会注意到手或手臂出现疼痛、刺痛或麻木。这些症状通常遵循“双重挤压”模式，即一个神经的问题会使另一个神经对压迫更加敏感。例如，尺神经（手臂小指侧的神经）的问题会增加患腕管综合征（腕部正中神经受压）的风险。由于全身性因素（如整体健康状况或炎症）会影响这些神经的反应，您可能会在多个区域感到症状。

不适的位置取决于哪个神经受到卡压。如果尺神经在肘部或腕部受压，您可能会在小指和无名指感到疼痛或无力。在腕部，这称为尺管综合征。囊肿（称为腱鞘囊肿）是这种特定压迫的最常见原因。如果腕部的正中神经受到影响，您可能会出现典型的腕管综合征症状。罕见情况下，假性痛风（关节内晶体沉积）或肿瘤等疾病可能导致突然的急性神经压迫。

您的症状通常在活动时加重。腕管内压力在您主动使用手部时会显著升高，这可能会加重腕管综合征。您可能会发现，将手伸到背后扣内衣、将衬衫塞进裤子或提举物体变得困难。夜间发作很常见，因为侧卧睡觉会增加对神经的压力。由于近端压迫部位常被忽视，即使卡压位置在手臂更高处，您仍可能在前臂或手部感到疼痛。您的外科医生将评估这些模式，以确定问题是机械性的、全身性的，还是两者的结合。

实际发生了什么

您的神经就像电缆，将来自大脑的信号传递到双手和手指。当这些神经受到挤压或压迫时，信号会被阻断或扭曲。这就是您感到疼痛、麻木或无力的原因。在上臂和手部，这种挤压通常是由于“双重挤压”机制引起的。这意味着神经可能在某一部位受到刺激，使其对附近另一部位的压迫更加敏感。

多种因素可导致这种挤压。有时，这只是您使用双手的方式所致。例如，当您主动使用手部时，腕管内压力会显著升高。这种压力增加可压迫正中神经。其他时候，则是由物理性阻塞引起。一种称为神经周围脂肪瘤的小型脂肪肿块可在肘部尺神经周围生长。或者，如果您以前有过腕骨骨折，尖锐的骨碎片甚至手术植入物可直接压迫神经。

您身体的整体健康状况也起着重要作用。全身性因素，如糖尿病或炎症，可使神经更容易受到压迫。有趣的是，一个神经的问题可能导致另一个神经出现问题。例如，如果您的尺神经已经受到刺激，您后来更有可能发展为腕管综合征。这是因为当一个神经功能异常时，您手部的运动和自主控制方式会发生变化。

有时，问题始于肌肉如何控制手部。腕部受伤后，您可能会丧失部分感觉运动控制，从而改变神经上的压力分布。在极少数情况下，结节性硬化症等疾病可导致肿瘤压迫神经，甚至在儿童中也是如此。您的外科医生会综合考虑所有这些情况——您的解剖结构、病史和症状——以准确了解压迫发生的具体位置和原因。这有助于选择正确的治疗方案，以缓解压迫并恢复功能。

我们能采取的措施

保守治疗可使大多数表现为轻度或中度症状的肘管综合征患者受益。您的外科医生通常会首先采用此方法。该方案侧重于减轻对神经的压力。您可能被建议调整日常习惯。例如，避免长时间屈肘会有所帮助。物理治疗旨在保持关节活动度并强化周围肌肉。这种支持有助于保护神经免受进一步刺激。请给予非手术方案足够的起效时间。大多数人无需手术即可看到改善。

如果简单措施效果不足，您的外科医生可能会讨论药物治疗。这通常包括使用止痛药或抗炎药以减轻肿胀。在某些情况下，会采用注射疗法将药物直接送达患处。皮质类固醇注射可减轻炎症和疼痛。透明质酸注射可润滑关节间隙。富血小板血浆（PRP）注射利用您自身的血液成分促进愈合。这些治疗针对刺激的根源。注射疗效因人而异。有些可缓解数周，而有些可能持续数月。您的外科医生将根据您的具体症状帮助您判断是否适合采取此步骤。

当保守治疗达到极限时，会考虑手术。这通常发生在尽管接受其他治疗，疼痛仍持续或神经功能恶化时。手术方案涉及减压。这意味着您的外科医生会松解压迫神经的紧张结构。这为神经愈合创造了更多空间。在某些情况下，例如存在肿瘤时，切除肿块并进行减压可提供缓解。可采用微创技术以缩小切口。这些方法旨在最大限度地减少出血和恢复时间。如果需要，您的外科医生将解释具体的手术方案。目标是停止压迫并恢复正常的神经功能。

预期情况

您的预后主要取决于神经受压缓解的速度。如果早期诊断并得到谨慎治疗，大多数患者会获得良好的功能恢复。您可以预期随着神经愈合，症状会逐渐缓解。对许多人来说，这意味着手部和手臂功能恢复正常。然而，如果症状已存在很长时间，则可能无法完全恢复。神经信号的恢复需要时间，而长期的压迫会导致不可逆的改变。

治疗决策因受累的具体神经而异。对于腕管综合征等常见问题，手术通常能提供持久的缓解。即使您患有糖尿病，这一益处依然成立。您的长期改善程度可能与非糖尿病患者的改善程度相似。在更复杂的情况下，如肘部严重的尺神经卡压，微创技术既安全又有效。这些方法旨在以最小干扰周围组织的方式松解神经。随着时间的推移，您可能会注意到力量和感觉方面的持续改善。

重要的是要明白，管理过程并不总是简单的。可能会出现并发症，包括邻近结构损伤、治疗失败或慢性疼痛综合征的发生。当您的外科医生对您的独特解剖结构有深刻理解时，这些风险会降至最低。在某些情况下，初始治疗可能无法完全解决问题。复发性或持续性压迫可能难以管理。如果症状复发，您的外科医生可能会讨论其他选择，例如使用胶原包裹来保护神经或转移其他神经以恢复功能。

如果不进行治疗，压迫性神经病变通常会持续或加重。神经上的压力通常不会自行缓解。在某些情况下，一个部位的神经受压会使您更容易在其他部位发生受压。例如，尺神经问题有时可能先于正中神经问题出现。因此，及时评估至关重要。虽然关于罕见上肢疾病的出版物大多基于较小的研究，但一般原则保持不变：早期且准确的减压是实现完全恢复日常活动的最佳机会。

何时就医

若疼痛持续且休息后无改善，请咨询全科医生。若发现手部无力或不稳，请要求专科评估。若症状干扰睡眠或工作，请寻求医疗帮助。症状突然加重也需要关注。压迫性神经病变可能涉及“双重挤压”机制，即一处神经问题会增加对另一处神经问题的易感性。全身性因素也可能导致这些疾病。例如，尺神经问题可能先于正中神经受压。需注意，腕部和前臂的合并症常被忽视。早期评估有助于预防病理性疼痛综合征或治疗失败等并发症。您的外科医生依靠对正常解剖结构的理解来安全地处理这些复杂病例。

Reviewed by Kieran Hirpara · 27 April 2026.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

Overview

  • Compression neuropathies of the upper extremity involve pathophysiology, clinical evaluation, and management considerations including the double-crush mechanism and systemic factors [1].
  • Validated patient-reported outcome measures are useful in the evaluation and management of upper extremity compression neuropathies [1].
  • Complications of compressive neuropathy management include iatrogenic injury, treatment failure, and pathologic pain syndromes [2].
  • Prevention of complications in compressive neuropathy management relies on a solid understanding of normal anatomy and anatomic variations [2].
  • Diagnosis and treatment of compressive neuropathies are evolving with technology, specifically shifting towards preoperative imaging with ultrasound and MRN [3].
  • Management of failed decompressions for compressive neuropathies remains challenging [3].
  • Most publications on uncommon upper extremity compression syndromes (radial, ulnar, and median nerves) are small retrospective series or case reports [4].
  • Treatment decisions for uncommon upper extremity compression syndromes are not typically based on high levels of evidence [4].
  • Debulking of a tumor along with median nerve decompression relieved neurological symptoms in a child with tuberous sclerosis complex causing carpal tunnel syndrome [5].
  • Minimally invasive in situ decompression is technically simple, safe, and provides good results for severe ulnar nerve entrapment at the elbow [6].
  • Ulnar nerve pathology may precede and increase susceptibility to median nerve compression, as indicated by the incidence of carpal tunnel syndrome after ulnar neuropathy diagnosis [8].
  • Use of a collagen matrix wrap in recurrent compression neuropathies of the upper extremity has shown good success [9].
  • Surgical decompression for carpal tunnel syndrome is associated with a greater decrease in median nerve cross-sectional area than nonsurgical treatment [10].
  • Anterior interosseous nerve transfer combined with cubital and ulnar tunnel release results in sustained clinical and electrophysiological improvements in severe chronic ulnar nerve compression [14].
  • Anterior interosseous nerve transfer combined with cubital and ulnar tunnel release is encouraged as a standard treatment for severe chronic ulnar nerve compression [14].
  • Endoscopic decompression for anterior interosseous nerve syndrome can achieve the same proximal and distal extents of the nerve as open techniques [15].
  • Endoscopic decompression for anterior interosseous nerve syndrome uses an incision nearly one fourth the size of open techniques, minimizing morbidity, blood loss, and recovery time [15].
  • Extensive decompression of the ulnar nerve beyond the cubital tunnel is not routinely needed, supported by satisfactory outcomes with endoscopic detection of compressing fascial bands within the FCU [17].

Anatomy & Pathophysiology

  • Compression neuropathies of the upper extremity involve a double-crush mechanism [1].
  • Systemic factors play a role in the pathophysiology of compression neuropathies of the upper extremity [1].
  • Intracarpal tunnel pressures during active hand use are substantially greater than previously reported in patients with carpal tunnel syndrome [21].
  • Perineural lipoma of the ulnar nerve can occur within the cubital tunnel [25].
  • Sensorimotor control impairment can occur after wrist trauma [27].
  • Distal radius fracture management requires evaluation of all potential causes for early carpal tunnel syndrome findings, including prominent volar cortical fragments causing direct pressure or prominently placed hardware [34].
  • Ulnar nerve entrapment neuropathy at the elbow is associated with non-task-specific focal hand dystonia [41].

Classification

  • Compression neuropathies of the upper extremity involve a double-crush mechanism [1].
  • Systemic factors contribute to the pathophysiology of compression neuropathies of the upper extremity [1].
  • Compressive neuropathy management complications include iatrogenic injury, treatment failure, and pathologic pain syndromes [2].
  • Prevention of compressive neuropathy complications relies on understanding normal anatomy and anatomic variations [2].
  • Diagnosis and treatment of compressive neuropathies are shifting towards preoperative imaging with ultrasound and MRN [3].
  • Management of failed decompressions for compressive neuropathies remains challenging [3].
  • Most publications on uncommon upper extremity compression syndromes (radial, ulnar, median nerves) are small retrospective series or case reports [4].
  • Treatment decisions for uncommon upper extremity compression syndromes are not typically based on high levels of evidence [4].
  • Debulking of a tumor along with median nerve decompression relieved neurological symptoms in a child with tuberous sclerosis complex causing carpal tunnel syndrome and thumb overgrowth [5].
  • Minimally invasive in situ decompression is technically simple, safe, and provides good results for severe ulnar nerve entrapment at the elbow [6].
  • Pseudogout is a rare cause of acute carpal tunnel syndrome and acute Guyon canal syndrome [7].
  • Ulnar nerve pathology may precede and increase susceptibility to median nerve compression [8].
  • Surgical decompression for carpal tunnel syndrome is associated with a greater decrease in median nerve cross-sectional area than nonsurgical treatment [10].
  • Concurrent carpal tunnel syndrome and pronator syndrome are rarely considered, and proximal compression sites are easily overlooked [11].
  • Ganglia are the most common cause of ulnar tunnel syndrome [12].
  • Symptoms of ulnar tunnel syndrome vary based on the anatomic location of the compression within Guyon's canal [12].
  • The term double crush syndrome is proposed to be expanded to multifocal neuropathy to describe the complex interplay of mechanical, systemic, pharmacological, and environmental factors contributing to nerve dysfunction [13].
  • Unusual compression neuropathies of the forearm include posterior interosseous nerve syndrome, radial tunnel syndrome, and superficial radial nerve compression (Wartenberg's syndrome) [16].
  • In-situ release is an alternative for managing McGowen grade 3 ulnar nerve compression neuropathy at the elbow, with a similar success rate to submuscular and intramuscular transpositions but a lower complication rate [23].

Clinical Presentation

  • Compression neuropathies of the upper extremity involve a double-crush mechanism [1].
  • Systemic factors contribute to the pathophysiology of compression neuropathies of the upper extremity [1].
  • Ulnar nerve pathology may precede and increase susceptibility to median nerve compression [8].
  • Concurrent carpal tunnel syndrome and pronator syndrome are rarely considered, and proximal compression sites are easily overlooked [11].
  • Intracarpal tunnel pressures during active hand use in patients with carpal tunnel syndrome are substantially greater than previously reported [21].
  • Ganglia are the most common cause of ulnar tunnel syndrome [12].
  • Symptoms of ulnar tunnel syndrome vary based on the anatomic location of the compression within Guyon's canal [12].
  • Pseudogout is a rare cause of acute neuropathic compression of the hand, including acute carpal tunnel syndrome and acute Guyon canal syndrome [7].
  • Collagenoma in a child with tuberous sclerosis complex can cause carpal tunnel syndrome and thumb overgrowth [5].
  • Uncommon compression syndromes of the radial, ulnar, and median nerves exist, with most publications being small retrospective series or case reports [4].
  • Unusual compression neuropathies of the forearm include posterior interosseous nerve syndrome, radial tunnel syndrome, and superficial radial nerve compression (Wartenberg's syndrome) [16].
  • A punched nerve syndrome of the deep motor branch of the ulnar nerve is a rare presentation [18].
  • Multifocal neuropathy describes the complex interplay of mechanical, systemic, pharmacological, and environmental factors contributing to nerve dysfunction [13].

Investigations

  • Diagnosis and treatment of compressive neuropathies are shifting towards preoperative imaging with ultrasound and MRN [3].
  • Most publications on uncommon upper extremity compression syndromes are small retrospective series or case reports, and treatment decisions are not typically based on high levels of evidence [4].
  • Debulking of a tumor along with median nerve decompression relieved neurological symptoms in a child with tuberous sclerosis complex causing carpal tunnel syndrome [5].
  • Pseudogout is a rare cause of acute neuropathic compression of the hand, including acute carpal tunnel syndrome and acute Guyon canal syndrome [7].
  • Ulnar nerve pathology may precede and increase susceptibility to median nerve compression [8].
  • Concurrent carpal tunnel syndrome and pronator syndrome are rarely considered, and proximal compression sites are easily overlooked [11].
  • Ganglia are the most common cause of ulnar tunnel syndrome, and symptoms vary based on the anatomic location of the compression within Guyon's canal [12].
  • Endoscopic decompression for anterior interosseous nerve syndrome can be achieved over the same proximal and distal extents of the nerve as open techniques but with an incision nearly one fourth the size, minimizing morbidity, blood loss, and recovery time [15].
  • Unusual compression neuropathies of the forearm specifically include posterior interosseous nerve syndrome, radial tunnel syndrome, and superficial radial nerve compression (Wartenberg's syndrome) [16].
  • High-resolution ultrasound (HRUS) is a viable method to demonstrate a punched nerve syndrome of the deep motor branch of the ulnar nerve [18].
  • Ultrasound measurements have limited value in predicting clinical results of patients treated for entrapment neuropathy of the ulnar nerve [19].
  • After surgery for perineural lipoma of the ulnar nerve within the cubital tunnel, shooting pain resolved, sensation normalized in digits four and five, and hand strength gradually improved [25].
  • The diagnostic accuracy of nerve conduction studies for ulnar neuropathy at the elbow may be lower than 80%–90% and depends on the severity of the neuropathy [33].
  • Short segment testing is suggested to improve the diagnostic accuracy of nerve conduction studies for ulnar neuropathy at the elbow [33].

Treatment

  • Conservative treatment benefits the majority of patients with cubital tunnel syndrome who present with mild or moderate symptoms [22].
  • Surgical decompression is associated with a greater decrease in median nerve cross-sectional area compared to nonsurgical treatment [10].
  • Debulking of a tumor along with median nerve decompression provides relief of neurological symptoms in cases such as collagenoma causing carpal tunnel syndrome [5].
  • Minimally invasive in situ decompression is technically simple, safe, and yields good results for severe ulnar nerve entrapment at the elbow [6].
  • In-situ release is an alternative for managing McGowen grade 3 ulnar nerve compression neuropathy at the elbow, offering a similar success rate to submuscular and intramuscular transpositions with a lower complication rate [23].
  • Anterior interosseous nerve transfer combined with cubital and ulnar tunnel release results in sustained clinical and electrophysiological improvements in patients with severe chronic ulnar nerve compression [14].
  • Minimally invasive endoscopic decompression for anterior interosseous nerve syndrome achieves the same proximal and distal extents of the nerve as open techniques but with an incision nearly one-fourth the size, minimizing morbidity, blood loss, and recovery time [15].
  • Extensive decompression of the ulnar nerve beyond the cubital tunnel is not routinely needed, as satisfactory outcomes are supported by endoscopic detection of compressing fascial bands within the flexor carpi ulnaris [17].
  • A novel technique using a collagen matrix wrap in recurrent compression neuropathies has shown good success [9].
  • Pseudogout should be considered a rare cause of acute neuropathic compression of the hand, including acute carpal tunnel syndrome and acute Guyon canal syndrome [7].
  • Complications of compressive neuropathy management include iatrogenic injury, treatment failure, and pathologic pain syndromes, with prevention relying on a solid understanding of normal anatomy and anatomic variations [2].
  • The management of failed decompressions remains challenging as diagnosis and treatment evolve with technology, shifting towards preoperative imaging with ultrasound and MRN [3].

Complications

  • Complications of compressive neuropathy management include iatrogenic injury [2].
  • Complications of compressive neuropathy management include treatment failure [2].
  • Complications of compressive neuropathy management include pathologic pain syndromes [2].
  • Prevention of complications relies on a solid understanding of normal anatomy and anatomic variations [2].
  • Management of failed decompressions remains challenging [3].
  • Nerve injuries following elbow arthroscopy are likely under-reported in the literature [29].
  • The number of severe nerve injuries following elbow arthroscopy may be much higher than previously thought [29].

Recovery

  • Minimally invasive in situ decompression for severe ulnar nerve entrapment at the elbow is technically simple, safe, and provides good functional outcomes [6].
  • Endoscopic decompression of the anterior interosseous nerve achieves the same proximal and distal extents as open techniques but with an incision nearly one-fourth the size, minimizing morbidity, blood loss, and recovery time [15].
  • Extensive decompression of the ulnar nerve beyond the cubital tunnel is not routinely needed, as satisfactory outcomes are supported by endoscopic detection of compressing fascial bands within the flexor carpi ulnaris [17].
  • Revision decompression combined with a collagen nerve wrap demonstrates good success in managing recurrent and persistent compression neuropathies of the upper extremity [9].
  • Anterior interosseous nerve transfer combined with cubital and ulnar tunnel release results in sustained clinical and electrophysiological improvements in patients with severe chronic ulnar nerve compression [14].
  • Early diagnosis and careful excision of epineural ganglia causing ulnar nerve compression in the cubital tunnel are associated with satisfactory outcomes, although complete electrophysiological recovery may not occur if symptoms have been present for a prolonged period [20].
  • Debulking of a tumor along with median nerve decompression provides relief of neurological symptoms in cases such as collagenoma-induced carpal tunnel syndrome [5].
  • Long-term improvement following carpal tunnel release in patients with diabetes is maintained to the same extent as in patients without diabetes [24].
  • Treatment decisions for uncommon upper extremity compression syndromes are not typically based on high levels of evidence, as most publications are small retrospective series or case reports [4].
  • Management of failed decompressions remains challenging despite evolving diagnostic and treatment technologies such as preoperative ultrasound and MRN [3].

Key Evidence

  • [L5] Complications of compressive neuropathy management include iatrogenic injury, treatment failure, and pathologic pain syndromes, with prevention relying on a solid understanding of normal anatomy and anatomic variations. [2] (10.1016/j.hcl.2015.01.012)
  • [L5] The diagnosis and treatment of compressive neuropathies continue to evolve with technology, shifting towards preoperative imaging with ultrasound and MRN, while the management of failed decompressions remains challenging. [3] (10.1016/j.jhsg.2022.10.009)
  • [L4] This article reviews uncommon compression syndromes of the radial, ulnar, and median nerves, noting that most publications are small retrospective series or case reports and treatment decisions are not typically based on high levels of evidence. [4] (10.1016/j.hcl.2013.04.014)
  • [Case_report] Debulking of the tumor along with median nerve decompression was performed with relief of neurological symptoms. [5] (10.1016/j.jhsa.2013.07.004)
  • [L3] Minimally invasive in situ decompression is technically simple, safe and gives good results in patients with severe nerve compression. [6] (10.1177/1753193411416426)
  • [L4] Pseudogout should be considered a rare cause of acute neuropathic compression of the hand. [7] (10.1016/j.jhsg.2022.07.010)
  • [L2] This supports the hypothesis that ulnar nerve pathology may precede and increase susceptibility to median nerve compression. [8] (10.1016/j.jhsg.2026.100970)
  • [L4] The authors report on the novel technique of using a collagen matrix wrap in recurrent compression neuropathies with good success. [9] (10.1097/sap.0b013e3182956475)
  • [L3] Surgical decompression was associated with a greater decrease in median nerve cross-sectional area than nonsurgical treatment. [10] (10.1016/j.jhsa.2010.06.010)
  • [L4] Concurrent carpal tunnel syndrome and pronator syndrome are rarely considered and proximal compression sites are easily overlooked. [11] (10.1016/j.otsr.2016.10.009)
  • [L5] The article provides a comprehensive review of the anatomy, pathophysiology, and causes of ulnar tunnel syndrome, noting that ganglia are the most common cause and that symptoms vary based on the anatomic location of the compression within Guyon's canal. [12] (10.1016/j.hcl.2007.06.006)
  • [L5] The authors propose expanding the term from double crush syndrome to multifocal neuropathy to better describe the complex interplay of mechanical, systemic, pharmacological, and environmental factors contributing to nerve dysfunction. [13] (10.1016/j.jhsa.2016.09.009)
  • [L4] Anterior interosseous nerve transfer, along with cubital and ulnar tunnel release, results in sustained clinical and electrophysiological improvements in patients with severe chronic ulnar nerve compression, which encourages its adoption as a standard treatment for severe chronic ulnar nerve compression. [14] (10.1177/17531934251381023)
  • [L4] Endoscopic decompression can be achieved over the same proximal and distal extents of the nerve as open techniques but with an incision nearly one fourth the size, minimizing morbidity, blood loss, and recovery time. [15] (10.1016/j.jhsa.2013.07.026)
  • [L5] This article is a review examining unusual compression neuropathies of the forearm, specifically focusing on the radial nerve, including posterior interosseous nerve syndrome, radial tunnel syndrome, and superficial radial nerve compression (Wartenberg's syndrome). [16] (10.1016/j.jhsa.2009.10.016)
  • [L4] The satisfactory outcomes support the perception that extensive decompression of the ulnar nerve beyond the cubital tunnel is not routinely needed. [17] (10.1007/s11552-011-9377-x)
  • [L4] HRUS is a viable method to demonstrate a punched nerve syndrome. [18] (10.1007/s00402-015-2216-8)
  • [L3] Ultrasound (US) measurements seem to have a limited value in clinical results of patients treated for entrapment neuropathy of the ulnar nerve. [19] (10.1177/1558944719857816)
  • [Case_report] Early diagnosis and careful excision of epineural ganglia are associated with satisfactory outcomes, although complete electrophysiological recovery may not occur if symptoms have been present for a prolonged period. [20] (10.1007/s11552-006-9013-3)
  • [L4] In patients with carpal tunnel syndrome, intracarpal tunnel pressures during active hand use are substantially greater than previously reported. [21] (10.1016/j.jhsa.2009.09.019)
  • [L2] The majority of patients suffering from cubital tunnel syndrome with mild or moderate symptoms benefit from conservative treatment. [22] (10.1177/1753193408098480)
  • [L4] Thus, in-situ release could be an alternative in management of patients with McGowen grade 3 ulnar nerve compression neuropathy at the elbow with a similar success rate as the submuscular and intramuscular transpositions with a lower complication rate. [23] (10.1016/j.jhsa.2015.06.068)
  • [L2] Long-term improvement in patients with diabetes remained after carpal tunnel release to the same extent as for patients without diabetes. [24] (10.1016/j.jhsa.2014.01.012)
  • [L4] After surgery, shooting pain resolved, sensation normalized in digits four and five, and hand strength gradually improved. [25] (10.1016/j.jhsg.2025.100889)
  • [L5] This clinical review discusses the organization, neuroanatomy, assessment, clinical relevance, and rehabilitation of sensorimotor control impairment after wrist trauma, proposing promising rehabilitation strategies that require more rigorous evaluation in clinical trials. [27] (10.1016/j.jht.2015.12.003)
  • [L4] Nerve injuries are likely under-reported in the literature, and this study indicates that the number of severe nerve injuries may be much higher than previously thought. [29] (10.1016/j.jhsa.2013.08.025)
  • [L5] The diagnostic accuracy of nerve conduction studies for ulnar neuropathy at the elbow may be lower than 80%–90% and depends on the severity of the neuropathy; short segment testing is suggested to improve accuracy. [33] (10.1177/17531934241288802)
  • [Paper] If early carpal tunnel syndrome findings are noted during distal radius fracture management, all potential causes should be evaluated, including prominent volar cortical fragments causing direct prominently placed hardware. [34] (10.1016/j.ocl.2012.07.021)
  • [L4] This case establishes a clear-cut relationship between ulnar nerve entrapment neuropathy at the elbow and non-task-specific focal hand dystonia, demonstrated by the dramatic recovery of clinical and electrophysiological parameters after surgical decompression. [41] (10.1007/s11552-010-9280-x)

References

[1] Compression Neuropathies of the Upper Extremity. 2021. [2] Complications of Compressive Neuropathy. Hand Clinics. 2015. DOI: 10.1016/j.hcl.2015.01.012 [3] Future Considerations in the Diagnosis and Treatment of Compressive Neuropathies of the Upper Extremity. Journal of Hand Surgery Global Online. 2023. DOI: 10.1016/j.jhsg.2022.10.009 [4] Uncommon Upper Extremity Compression Neuropathies. Hand Clinics. 2013. DOI: 10.1016/j.hcl.2013.04.014 [5] Collagenoma in a Child With Tuberous Sclerosis Complex Causing Carpal Tunnel Syndrome and Thumb Overgrowth: Case Report. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2013.07.004 [6] Severe ulnar nerve entrapment at the elbow: functional outcome after minimally invasive in situ decompression. Journal of Hand Surgery (European Volume). 2012. DOI: 10.1177/1753193411416426 [7] Pseudogout: A Rare Cause of Acute Carpal Tunnel Syndrome and Acute Guyon Canal Syndrome. Journal of Hand Surgery Global Online. 2022. DOI: 10.1016/j.jhsg.2022.07.010 [8] Incidence of Carpal Tunnel Syndrome After the Diagnosis of Ulnar Neuropathy. Journal of Hand Surgery Global Online. 2026. DOI: 10.1016/j.jhsg.2026.100970 [9] Revision Decompression and Collagen Nerve Wrap for Recurrent and Persistent Compression Neuropathies of the Upper Extremity. Annals of Plastic Surgery. 2014. DOI: 10.1097/sap.0b013e3182956475 [10] Sonographic Follow-Up of Patients With Carpal Tunnel Syndrome Undergoing Surgical or Nonsurgical Treatment: Prospective Cohort Study. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2010.06.010 [11] Concurrent carpal tunnel syndrome and pronator syndrome: A retrospective study of 21 cases. Orthopaedics & Traumatology: Surgery & Research. 2017. DOI: 10.1016/j.otsr.2016.10.009 [12] Ulnar Tunnel Syndrome. Hand Clinics. 2007. DOI: 10.1016/j.hcl.2007.06.006 [13] Multifocal Neuropathy: Expanding the Scope of Double Crush Syndrome. The Journal of Hand Surgery. 2016. DOI: 10.1016/j.jhsa.2016.09.009 [14] Anterior interosseous nerve transfer combined with cubital and ulnar tunnel release for severe ulnar nerve compression. Journal of Hand Surgery (European Volume). 2025. DOI: 10.1177/17531934251381023 [15] Minimally Invasive Endoscopic Decompression for Anterior Interosseous Nerve Syndrome: Technical Notes. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2013.07.026 [16] Unusual Compression Neuropathies of the Forearm, Part I: Radial Nerve. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2009.10.016 [17] Endoscopic Detection of Compressing Fascial Bands around the Ulnar Nerve within the FCU. HAND. 2011. DOI: 10.1007/s11552-011-9377-x [18] A rare case of a punched nerve syndrome of the deep motor branch of the ulnar nerve. Archives of Orthopaedic and Trauma Surgery. 2015. DOI: 10.1007/s00402-015-2216-8 [19] Sonographic Follow-Up of Patients With Cubital Tunnel Syndrome Undergoing in Situ Open Neurolysis or Endoscopic Release: The SPECTRE Study. HAND. 2019. DOI: 10.1177/1558944719857816 [20] Ulnar Nerve Compression in the Cubital Tunnel by an Epineural Ganglion: A Case Report. HAND. 2007. DOI: 10.1007/s11552-006-9013-3 [21] Dynamics of Intracarpal Tunnel Pressure in Patients With Carpal Tunnel Syndrome. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2009.09.019 [22] Conservative Treatment of the Cubital Tunnel Syndrome. Journal of Hand Surgery (European Volume). 2009. DOI: 10.1177/1753193408098480 [23] The Efficacy of In-Situ Cubital Tunnel Release in Management of Elbow Ulnar Compression Neuropathy in McGowen Grade 3. The Journal of Hand Surgery. 2015. DOI: 10.1016/j.jhsa.2015.06.068 [24] Carpal Tunnel Release in Patients With Diabetes: A 5-Year Follow-Up With Matched Controls. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2014.01.012 [25] Perineural Lipoma of the Ulnar Nerve Within the Cubital Tunnel: A Brief Review of the Literature. Journal of Hand Surgery Global Online. 2026. DOI: 10.1016/j.jhsg.2025.100889 [27] Rehabilitation strategies for wrist sensorimotor control impairment: From theory to practice. Journal of Hand Therapy. 2016. DOI: 10.1016/j.jht.2015.12.003 [29] Nerve Injuries Following Elbow Arthroscopy. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2013.08.025 [33] Re: Bourke G, Wade R, van Alfen N. Updates in diagnostic tools for diagnosing nerve injuries and compressions. J Hand Surg Eur. 2024, 49: 668–80. Journal of Hand Surgery (European Volume). 2024. DOI: 10.1177/17531934241288802 [34] Carpal Tunnel Syndrome After Distal Radius Fracture. Orthopedic Clinics of North America. 2012. DOI: 10.1016/j.ocl.2012.07.021 [41] Focal Hand Dystonia in a Patient with Ulnar Nerve Neuropathy at the Elbow. HAND. 2010. DOI: 10.1007/s11552-010-9280-x

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