Ulnar Nerve Injury

　　After the ulnar nerve injury, the ulnar side of the hand loses the sensation of the entire little finger and the ulnar side of the ring finger. The deep branch of the ulnar nerve is the motor branch, which is sometimes injured by piercing or penetrating wounds. The causes of ulnar nerve injury include the following points:

　　1. Compression injuries are the most common, caused by direct violence to the nerve, often severe and often accompanied by nerve defects.

　　2. Stretch injuries, such as fractures of the medial epicondyle of the humerus in the elbow, double fractures of the ulna and radius in the forearm, and fractures of the carpal bones of the wrist, can directly stretch the ulnar nerve and cause injury.

　　3. At the elbow, the ulnar nerve can be injured directly or as a combined injury with fracture and dislocation.

　　4. Laceration injuries at the wrist and elbow are common.

　　5. When the patient is under general anesthesia, if the arms are not protected and hang over the edge of the operating table, paralysis may occur due to compression.

　　6. In the cervical rib or anterior scalene muscle syndrome, the ulnar nerve is most commonly damaged.

　　After the ulnar nerve injury, the ulnar side of the hand loses the sensation of the entire little finger and the ulnar side of the ring finger. The deep branch of the ulnar nerve is the motor branch, which is sometimes injured by piercing or penetrating wounds. What complications may occur with ulnar nerve injury?

　　For patients with severe ulnar nerve injury, there may be sensory hypoesthesia in the支配 area, atrophy of the hypothenar muscle, and interosseous muscles.

　　After the ulnar nerve injury, the ulnar side of the hand loses the sensation of the entire little finger and the ulnar side of the ring finger. The deep branch of the ulnar nerve is the motor branch, which is sometimes injured by piercing or penetrating wounds. At the wrist, the ulnar nerve is prone to laceration injuries, and the superficial branch of the ulnar nerve is also prone to laceration injuries in the fingers and palm. What are the symptoms of ulnar nerve injury?

　　1. Movement

　　On the injury above the elbow, the ulnar wrist flexor and the ulnar half of the deep flexor of the fingers are paralyzed and atrophic, and cannot flex the wrist towards the ulnar side and the distal interphalangeal joint of the little finger. When the fingers are flat, the little finger cannot climb the table surface. The hand intrinsic muscles are widely paralyzed, including the hypothenar, interosseous muscles, the third and fourth lumbricals, the adductor pollicis, and the medial head of the flexor pollicis brevis. There are obvious indentations in the hypothenar and metacarpal spaces. The ring finger and the little finger have claw-like deformities. The claw-like deformity above the elbow injury is relatively mild; if the distal injury of the deep flexor muscle nerve is due to the loss of the opposing action of the hand intrinsic muscles, the claw-like deformity is obvious, that is, the metacarpophalangeal joint of the ring and little fingers is hyperextended and the interphalangeal joints are flexed. It is not possible to extend the interphalangeal joints at the same time as flexing the metacarpophalangeal joints. Due to the opposing action of the radial two lumbricals, the index and middle fingers do not have claw-like deformities or only have slight deformities. The fingers cannot be adducted or abducted. The paper pinch test is positive. The thumb and index finger cannot form a complete 'O' shape when they are pinched together, and the pinch test of these two fingers shows weakness, which is due to the paralysis of the adductor pollicis and the inability to stabilize the metacarpophalangeal joint of the thumb. There is a pinch obstruction between the little finger and the thumb. Due to the paralysis of the hand intrinsic muscles, the grip strength of the hand decreases by about 50%, and the flexibility of the hand is lost.

　　2, Sensation

　　The ulnar side of the hand, the entire little finger, and the ulnar side of the ring finger all lose sensation.

　　There is no special preventive method for ulnar nerve injury, and it should be avoided as much as possible to prevent trauma. The patient's diet should be light and easy to digest, with an emphasis on eating more fruits and vegetables, and a reasonable diet should be balanced, ensuring adequate nutrition. In addition, patients should avoid spicy, greasy, and cold foods.

　　Ulnar nerve injury is most common in wrist and elbow incisions. When diagnosing ulnar nerve injury, in addition to relying on clinical manifestations, auxiliary examinations are also needed. Physical examination is the main method for this disease. Electromyography may be performed if necessary.

　　For ulnar nerve injury, dietary quality and quantity should be scientifically matched. Calcium is the main component of bones, so it should be fully absorbed. It is not necessary to mention growth, but bones also need to undergo metabolism continuously after adulthood. In addition, calcium has a calming effect on the mind and can help relieve pain. Foods rich in calcium include fish, milk, yogurt, sesame, dark green vegetables, seaweed. Foods rich in vitamin B include brown rice, white rice, soybeans, peanuts, sesame, dark green vegetables.

　　Protein is an indispensable nutrient for the formation of muscles, tendons, and bones. Foods rich in protein include pork, chicken, beef, liver, fish, shellfish, cheese, eggs, soybeans, and soy products.

　　Ulnar nerve injury is most commonly caused by compression injury, which is direct violence. How should ulnar nerve injury be treated?

　　The treatment of ulnar nerve injury should be based on the condition of the injury, including decompression, release, or anastomosis. To obtain length, the ulnar nerve can be moved to the anterior elbow. The effect of ulnar nerve anastomosis is not as good as that of the radial nerve and median nerve. The radial nerve is mainly motor fibers, the median nerve is mainly sensory fibers, and the ulnar nerve has roughly equal sensory and motor fibers, so it is especially important to ensure accurate alignment and avoid rotation during suture. Simple suture of sensory and motor branches at the distal ulnar nerve results in good effects. If there is no recovery, the intrinsic extensors of the index and little fingers and the superficial flexor muscles of the middle ring finger can be transferred to replace the interosseous muscles and lumbricals, thereby improving hand function.