The most common place to have ulnar nerve injury is at the elbow, where the nerve is anatomically most exposed and vulnerable as it traverses superficially in the ulnar groove. Pressure at the elbow such as with prolonged elbow weight bearing, coma, intoxication, or anesthesia can account for this problem.
Cubital tunnel syndrome occurs when the nerve is compressed as it runs beneath the aponeurosis of the flexor carpi ulnaris just distal to the medial epicondyle (cubital tunnel). Activities that involve repetitive or sustained elbow flexion, such as baseball pitching, can injure and stretch the nerve. This results in hypermobility of the ulnar nerve and allows recurrent subluxation over the medial epicon-dyle. Common symptoms include paresthesias or pain in the ring and small fingers and dorsoulnar aspect of the hand and forearm. There may be generalized loss of grip or fine motor control in the hand because of impairment of the intrinsic muscles. Symptoms may improve with elbow extension. Recurrent subluxation of the ulnar nerve at the elbow, especially in young throwing athletes, often requires surgical intervention.
Ulnar neuropathy distal to the elbow usually presents as ulnar tunnel syndrome when the nerve is compressed within Guyon's canal in the wrist. Prolonged pressure over the hypothenar eminence, as occurs with cycling, is a common cause, as are similar causes listed for CTS. Dysesthesias may or may not be present in the ulnar regions. Depending on where the specific entrapment occurs, all the intrinsic hand muscles may be weak, or hypothenar function may be selectively preserved.
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Since World War II, there has been a tremendous change in the makeup and direction of kid baseball, as it is called. Adults, showing an unprecedented interest in the activity, have initiated and developed programs in thousands of towns across the United States programs that providebr wholesome recreation for millions of youngsters and are often a source of pride and joy to the community in which they exist.