Evidence-Based Management of Ulnar Neuropathy at the Elbow

Ulnar neuropathy at the elbow (UNE) is the second most common entrapment neuropathy and can result in severe loss of function of the hand. This review will cover up to date anatomy, pathophysiology, diagnostic assessment, and treatment of UNE.

In cases of suspected UNE with normal electrodiagnostic assessment (EDx), neuromuscular ultrasound (NMU) and MRI have been shown to increase diagnostic sensitivity. A variety of treatment options exist including activity modification, bracing, physical therapy, ESWT, injections, hydrodissection, surgical decompression, and surgical functional restoration. A Delphi survey recommended standardized outcome measures to be utilized for ongoing research due to heterogenous existing literature.

UNE diagnosis can be reliably achieved in patients with compatible signs and symptoms in conjunction with the use of diagnostics tests including EDx, NMU, and MRI. A large variety of non-surgical and surgical treatment options exist, however, there is lacking consensus regarding optimal treatment choice.