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Showing 3 results for Ulnar Nerve

Spaghetti Wrist: Management and Outcomes

Fereidoun Layeghi , Maryam Farzad ,
Volume 6, Issue 4 (1-2006)

Abstract

Objective: The aim of this survey is to determine of emergency management of spaghetti wrist functional impairments due to these injuries which demands an adequate and accurate management of such injuries.

Materials & Methods: All the Patients with Spaghetti wrist (33 Persons) due to sharp injuny that was operated by one surgeon, presenting to hand Rehabilitation center whom includeded in this study, all of them were managed with early intervention programs by one therapist for 10 weeks, and they were assessed with mono semmes – weinstein mono filament asterwards.The effects of sex, age, time of surgery and outcomes were assessed.

Results: Thirty-three Patients were included in this survey. In evaluation of median nerve in the given time, non of them were not tested and 40/31% of them had diminished quality of light touch. In ulnar nerve impairoment 43/7% had diminished protective touch and in Pinch Grip evaluation we found that both unlar and median nerve injuries has most affect in increasing the power.

Conclusion: early surgery and early intervention has the best effect on spaghetti wrist Motor and sensory recovery found to be better in madian nevere injuries versus ulnar nerve ones.

Reliability of Upper Limb Neurodynamic Tests: Median, Radial, and Ulnar Nerves

Milad Taheri, Ghadamali Talebi, Mohammad Taghipour, Massoud Bahrami, Hemmat Gholinia,
Volume 23, Issue 3 (9-2022)

Abstract

Objective: Upper limb neurodynamic tests are used to evaluate the mechanical sensitivity of the peripheral nerves. However, very little is known about the reliability of upper limb neurodynamic tests, especially for the radial and ulnar nerves. This study aimed to evaluate the reliability of neurodynamic tests of the upper extremities to test median, radial, and ulnar nerves.
Materials & Methods: In this observational cross-sectional study, 25 asymptomatic subjects aged 19-45 years participated. They were selected using simple non-random sampling. Then two examiners performed the neurodynamic tests on them on two successive days. The goal was to assess the reliability of median, radial, and ulnar neurodynamic tests. During the neurodynamic tests, the participants reported the initial stretching pain and the moment of submaximal pain (substantially obvious pain) in related areas of the nerve distribution, including the anterior side of the elbow and forearm for the median nerve, posterolateral aspect of the elbow and forearm for radial nerve, and medial side of elbow and forearm for the ulnar nerve. At the starting point of painful stretching and the submaximal pain, the angle of elbow extension (for median and radial nerve tests) and shoulder abduction angle (for ulnar nerve test) were measured using a mechanical goniometer. The range between these two points was used to analyze the reliability. The intraclass correlation coefficient (ICC) and the standard error of measurement (SEM) were calculated to examine the relative and absolute reliability, respectively. Using t-test, the difference in the mean of the measurements was calculated.
Results: No significant difference was found between the mean measurements of the two testers in intra-session and inter-session reliability. For examiners 1 and 2, was obtained 0.94 (SEM:2ο) and 0.89 (SEM:2.85ο) for the median nerve, 0.56 (SEM:6.36˚ ) and 0.93 (SEM:1.82ο) for radial nerve, and 0.42 (SEM:3.27ο) and 0.79 (SEM:1.42ο) for the ulnar nerve. Inter-tester intra-session reliability was obtained at 0.84 (SEM: 3.44ο), 0.54 (SEM: 6.1ο), and 0.55 (SEM: 2.75ο), respectively, for median, radial, and ulnar nerves. Inter-tester inter-session reliability was obtained at 0.97 (SEM:1.43ο), 0.69 (SEM:5.06ο), and 0.51 (SEM: 2.8˚ο), respectively, for median, radial, and ulnar nerves.
Conclusion: The upper limb neurodynamic tests and measurement of the range between the onset of stretching pain and the point of submaximal pain have moderate to excellent reliability. Therefore, these clinical tests can be used in diagnostic evaluations and treatment interventions. Also, the median nerve neurodynamic test has higher relative reliability than radial and ulnar nerve neurodynamic tests.

Frequency of Adverse Neural Tension and Its Association With Functional Disability in Upper Extremity Musculoskeletal Pain Syndromes: A Cross-sectional Study

Milad Taheri, Ghadamali Talebi, Mohammad Taghipour, Massoud Bahrami, Hemmat Gholinia,
Volume 24, Issue 3 (9-2023)

Abstract

Objective Musculoskeletal pain syndrome (MPS) is one of the main causes of functional disability. Although the symptoms and complaints of patients with MPS are often related to their musculoskeletal structures, repeated microtraumas and overuse (the main causes of musculoskeletal pain) may also lead to abnormal neurodynamics. Abnormal neurodynamics refers to mechanical dysfunction in the movement of nerve structures related to the surrounding tissues or disruption in the normal elongation of the nerve. Some recent studies have suggested the possibility of abnormal neurodynamics in patients with MPS. Therefore, this study aims to determine the frequency of abnormal neural tension and its association with functional disability in patients with MPS of the upper extremity.
Materials & Methods A hundred participants with MPS (78 women and 22 men) participated in this study. Median, radial and ulnar nerve neurodynamic tests were performed according to Butler & Shacklock’s approach. There was a five-minute rest between each test to avoid the therapeutic effects of neurodynamic maneuvering. To quantitatively measure the intensity of the abnormal tension in the peripheral nerves in case of a positive neurodynamic test, the angle of the elbow joint in extension (for the median and radial nerves) and the angle of the shoulder joint in abduction (for the ulnar nerve) were measured using a standard goniometer. The association between abnormal neural tension and functional disability was investigated using Pearson's correlation test. The statistical significance level was set a t 0.05.
Results Regardless of the type of disorder, 112 patients had abnormal neural tension (some participants had more than one disorder) and underwent the neurodynamic test. Based on the results, 50 patients (50%) had at least one median, radial, or ulnar nerve tension dysfunction. There was no significant association between the degree of functional disability and the severity of abnormal neural tension according to the joint angle.
Conclusion In many patients with MPS of the upper extremity with no obvious symptoms of neurological dysfunction, the nerve neurodynamic test is positive. Therefore, it is recommended that in all patients diagnosed with MPS, nerve neurodynamic test and, if necessary, neurodynamic therapy should be included in the routine physiotherapy.

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