Hand Palsy

Ulnar nerve palsy This occurs due to nerve compression at the elbow (cubital tunnel) or at the wrist (Guyon's canal) (Ulnar canal) Muscle weakness and atrophy predominate the clinical presentation

Ulnar nerve palsy/Causes Cubital Tunnel Syndrome Frequent bending of the elbow Leaning on the elbow, resting it on an elbow,  rest during a long distance drive  or running machinery may cause repetitive pressure and irritation on the nerve. A direct hit on the cubital tunnel may damage the ulnar nerve Guyon's Canal Syndrome A cyst within the canal. Clotting of the ulnar artery. Fracture of the hamate bone. Arthritis of the wrist bones

Ulnar nerve palsy/Causes Symptoms & signs: numbness and tingling in the ring and little finger and the sides and back of the hand. At Guyon's Canal, sensory supply to the skin of the back of the hand is spared. The hand may become weaker resulting in trouble opening bottles or jars Clawing may occur in the ring and little fingers  Froment's test: by asking the patient to hold a piece of paper between their thumb and index finger (hence checking adductor pollicis). In a patient with Ulnar nerve palsy the interphalangeal joint of the thumb will flex to compensate Treatment: Nonsurgical therapy: elbow or wrist splints to limit mobility in addition to an anti-inflammatory drug such as ibuprofen. Surgical decompression maybe required in some cases

Froment's test

Radial nerve palsy Aka: wrist drop Saturday night palsy

Causes Caused by excessive compression of the radial nerve against a hard surface in individuals insensitized by the intake of alcohol or sedatives Broken humerus lead poisoning  Stab wounds to the chest at or below the clavicle. Damage the posterior cord of the brachial plexus Symptoms: Wrist drop Occasionally, the back of the hand may lose feeling

Wrist Drop

Erb’s Palsy Aka: Waiter's tip deformity Erb-Duchenne Palsy

Erb’s Palsy Due to brachial plexus damage, by excessive lateral neck flexion away from sholder: Forceps delivery Falling on the neck Leads to loss of the lateral rotators of the shoulder, arm flexors, and hand extensor muscles. The position of the limb, under such conditions, is characteristic: the arm hangs by the side and is rotated medially; the forearm is extended and pronated. The hand is flexed The arm cannot be raised from the side; all power of flexion of the elbow is lost, as is also supination of the forearm

Erb’s Palsy The three most common treatments from Erb's Palsy are: Nerve transfers (usually from the opposite leg), Sub Scapularis releases and Latissimus Dorsi Tendon Transfers. Although range of motion is recovered in many children under one year in age, individuals who have not yet healed after this point will rarely gain full function in their arm and may develop arthritis

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