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Compression Neuropathies

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Hand numbness, tingling, or weakness – understanding carpal tunnel, cubital tunnel, and other compression neuropathies.

Updated Aug 20262 citations

The median nerve (centre of the palm) supplies the thumb, index, middle and inner half of the ring finger; the ulnar nerve (along the little-finger side) supplies the little finger and outer half of the ring finger. Compression at the wrist or elbow shows up in these patterns. Kieran Hirpara 4.0

What you're feeling

You may notice tingling, numbness, or a dull ache in your hand or forearm. This happens when a nerve is squeezed or compressed. The pain often travels from your shoulder or elbow down to your fingers. You might feel weak in your grip, making it hard to hold objects securely.

Symptoms often worsen at night or after repetitive hand use. You may wake up with pins and needles in your fingers. Simple tasks like turning a steering wheel, holding a coffee cup, or typing can become difficult. Your hand might feel clumsy or uncoordinated. In some cases, you may drop things without warning.

The location of your discomfort depends on which nerve is affected. If the ulnar nerve is compressed near your elbow or wrist, you may feel pain in your ring and little fingers. If the median nerve is squeezed in your wrist (carpal tunnel syndrome), your thumb, index, and middle fingers are often involved. You might also experience sharp, shooting pains in your forearm if a different nerve branch is trapped.

Sometimes, symptoms in one nerve can make another nerve more sensitive to compression. This means you might have issues in both your wrist and elbow at the same time. Swelling or small fluid-filled sacs (ganglia) can press on nerves, causing sudden or gradual symptoms. In rare cases, conditions like pseudogout or skin growths can trigger acute nerve pain.

Your symptoms may flare up after activities that involve bending your elbow or gripping tools tightly. Resting your hand in a neutral position often brings relief. However, ignoring the compression can lead to persistent pain or weakness. It is important to understand that these symptoms are real and specific to the pressure on your nerves.

What's actually happening

Your nerves are like electrical cables that carry signals from your brain to your hands. They travel through tight tunnels formed by bones and ligaments. When these tunnels become too narrow, the nerve gets squeezed. This pressure stops the signals from flowing freely. You might feel tingling, numbness, or weakness as a result.

This squeezing often happens because of a 'double-crush' mechanism. This means a nerve can be irritated at two different points along its path. If one section is already sensitive, pressure at another spot can cause symptoms to flare up. Systemic factors, such as overall health conditions, can also make your nerves more vulnerable to this compression.

In your wrist, the pressure inside the carpal tunnel rises significantly when you actively use your hand. This dynamic pressure can irritate the median nerve. In your elbow, the ulnar nerve can be trapped within the cubital tunnel. Sometimes, a benign fatty growth called a perineural lipoma sits directly on the nerve, adding to the squeeze.

Previous injuries can also change how your tissues behave. Wrist trauma may impair how your hand senses movement and position. If you have had a distal radius fracture, bone fragments or surgical hardware might press directly against the nerve. In some cases, ulnar nerve issues at the elbow can make you more likely to develop carpal tunnel syndrome later.

Your surgeon will look for these specific causes. We use imaging like ultrasound and MRN to see exactly where the pressure is coming from. This helps us plan a treatment that relieves the squeeze without causing further injury. Understanding the exact anatomy ensures we target the right spot to free your nerve.

What we can do about it

Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, starts with the least invasive options that suit your condition. Patients are generally referred to our clinic by their GP; if a physiotherapist has suggested you see us, you will still need a referral from your GP in order to be eligible for the Medicare rebate. A clinic assessment, including history, examination, and imaging where needed, establishes the diagnosis. For degenerative or long-standing problems we usually try non-operative care — activity change, physiotherapy or hand therapy, splinting, and injections — and consider surgery when that has not given enough improvement.

Conservative treatment benefits the majority of patients with cubital tunnel syndrome who present with mild or moderate symptoms. We focus on helping you manage your symptoms through self-care and guided exercises. Physiotherapy aims to reduce pressure on the nerve and improve your movement. You might use splints to keep your joints in a comfortable position. We give this approach a fair chance to work before considering other steps.

Medical management focuses on reducing pain and inflammation. We may suggest pain medication or anti-inflammatories to help you feel better. In some cases, we consider injections such as cortisone, hyaluronic acid, or platelet-rich plasma (PRP). These treatments aim to calm the irritated area around the nerve. The effect of these injections varies, but they can provide relief while you continue with your rehabilitation.

Surgery is considered when conservative care has reached its limit. We look at your progress and symptoms to decide if this is the right step for you. Surgical options range from minimally invasive decompression to more complex procedures depending on the cause of the compression. For example, if a ganglion cyst or tumour is pressing on the nerve, we may remove it along with the decompression. In severe cases, we might use nerve transfers or novel techniques like collagen matrix wraps. We discuss the specific surgical option with you, ensuring you understand what it involves and what to expect during your recovery.

What to expect

Compression neuropathies involve pressure on nerves in your arm or hand. This pressure can cause pain, numbness, or weakness. The outlook depends on how long the symptoms have been present and how severe the compression is. In many cases, early diagnosis and careful treatment lead to satisfactory outcomes. However, if symptoms have persisted for a long time, complete recovery of nerve function may not occur, even with surgery.

When managed well, you can expect significant relief from neurological symptoms. For example, long-term improvement following carpal tunnel release is maintained to the same extent in patients with diabetes as in those without it. Minimally invasive techniques for severe ulnar nerve entrapment at the elbow are technically simple and safe, providing good functional results. Endoscopic approaches for anterior interosseous nerve syndrome use an incision nearly one-fourth the size of open techniques. This minimises blood loss and recovery time while achieving the same nerve release.

If left alone or if initial treatment fails, the condition can persist. Management of failed decompressions remains challenging, despite advances in diagnostic tools like ultrasound and MRN. Complications such as iatrogenic injury, treatment failure, or pathologic pain syndromes are possible. Prevention relies on a thorough understanding of normal anatomy and variations. For recurrent cases, revision decompression combined with a collagen nerve wrap has shown good success.

For uncommon compression syndromes, treatment decisions are often based on smaller studies rather than large trials. Ulnar nerve pathology may increase your susceptibility to median nerve compression later on. Validated patient-reported outcome measures help track your progress. While technology is evolving, the core principle remains: relieving pressure on the nerve. Your surgeon will tailor the approach to your specific anatomy and symptom history. Realistic expectations are key. You may experience sustained clinical improvements, but some electrophysiological changes may persist if the compression was chronic.

When to see someone

See your GP if you notice persistent numbness, tingling, or weakness in your hand or arm. Symptoms may worsen with hand use or disturb your sleep. Be aware that issues in one nerve can make others more vulnerable. Ask for a specialist review if pain persists despite rest, or if you experience unexplained swelling or lumps in your wrist. These signs may indicate pressure on the nerve that needs targeted assessment.

Go to an emergency department if you develop sudden, severe pain, rapid swelling, or a cold, pale hand. These could signal acute nerve compression or circulation loss. Early assessment is vital to prevent permanent damage. Do not wait for a routine appointment if symptoms appear suddenly or severely impact your ability to move your hand.

Advanced reading: the deeper science (optional)

This section goes further than you need for your own treatment decisions. Nerve compression in the arm is worth the extra reading because of a single figure that explains a large share of disappointing outcomes: a meaningful minority of people have more than one nerve compressed, and releasing the wrong one changes nothing.

Three percent need a second, different nerve released within a year

In a cohort of 7,867 patients undergoing surgery for nerve compression, approximately 3% underwent decompression of a different nerve in the same arm within one year — and patients with both carpal and cubital tunnel syndrome may benefit from simultaneous decompression, since outcomes were comparable to single decompression [1].

Three percent is small in absolute terms and large in what it implies. It counts only those who proceeded to a second operation within twelve months; it does not count those still symptomatic who did not, or those whose second site was recognised before the first operation. The true frequency of multi-site compression is higher than the surgical rate.

The clinical consequence is the important part: when a hand remains wrong after a technically sound release, the question is not only "did the operation fail" but "was there a second site all along".

Doing both at once does not appear to cost anything

The instinctive objection to simultaneous decompression is that two operations at once in the same limb must raise the risk — particularly of complex regional pain syndrome, a poorly understood condition of persistent pain and dysfunction that historically was reported at higher rates after combined procedures.

That concern has been examined directly. Analysing 753 patients, adding carpal tunnel release to those requiring fasciectomy showed only a marginal increase in the occurrence of CRPS, contradicting original reports demonstrating a much higher rate — indicating no clear clinical risk associated with simultaneous surgery [2].

Read alongside the finding that combined decompression gives outcomes comparable to single decompression [1], the case for addressing two demonstrated sites in one anaesthetic is reasonable rather than reckless.

The double crush idea, and what it does and does not explain

The observation that compression at one point along a nerve makes it more vulnerable at another is known as double crush. The proposed mechanism is that compression impairs the transport of materials along the nerve fibre, so a nerve already embarrassed proximally tolerates a second insult less well.

The concept is useful and frequently over-applied. It offers a real explanation for why someone with neck pathology may develop carpal tunnel symptoms at a lower threshold than expected, and why multi-site compression clusters in the same individuals. It is not a licence to attribute any unexplained arm symptom to a hypothetical second lesion, and it does not predict which patients will benefit from which release.

What this means practically

Two things follow. Before an operation, symptoms that do not fit the nerve being released — numbness in the ring and little fingers when a carpal tunnel release is planned, or vice versa — are worth raising explicitly, because the pattern is what identifies a second site.

And afterwards, persistent symptoms deserve reassessment of the diagnosis rather than assumption of a technical failure. The evidence above indicates that the second nerve is a real and recognised possibility, not an unusual excuse.

---

Reviewed by Kieran Hirpara · 27 April 2026.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

References for the advanced reading

1. Mendelaar NH, Hundepool CA, Hoogendam L, Duraku LS, Zöphel OT, Selles RW, et al. Multiple compression syndromes of the same upper extremity: prevalence, risk factors, and outcomes. J Hand Surg Am. 2023;48(5):479-88.
2. Buller M, Schulz S, Kasdan M, Wilhelmi BJ. The incidence of complex regional pain syndrome in simultaneous surgical treatment of carpal tunnel syndrome and Dupuytren contracture. Hand (N Y). 2017;13(4):391-4.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

• Compression neuropathies of the upper extremity involve pathophysiology, clinical evaluation, and management considerations including the double-crush mechanism and systemic factors [1].
• Validated patient-reported outcome measures are useful in the evaluation and management of upper extremity compression neuropathies [1].
• Complications of compressive neuropathy management include iatrogenic injury, treatment failure, and pathologic pain syndromes [2].
• Prevention of complications in compressive neuropathy management relies on a solid understanding of normal anatomy and anatomic variations [2].
• Diagnosis and treatment of compressive neuropathies are evolving with technology, specifically shifting towards preoperative imaging with ultrasound and MRN [3].
• Management of failed decompressions for compressive neuropathies remains challenging [3].
• Most publications on uncommon upper extremity compression syndromes (radial, ulnar, and median nerves) are small retrospective series or case reports [4].
• Treatment decisions for uncommon upper extremity compression syndromes are not typically based on high levels of evidence [4].
• Debulking of a tumor along with median nerve decompression relieved neurological symptoms in a child with tuberous sclerosis complex causing carpal tunnel syndrome [5].
• Minimally invasive in situ decompression is technically simple, safe, and provides good results for severe ulnar nerve entrapment at the elbow [6].
• Ulnar nerve pathology may precede and increase susceptibility to median nerve compression, as indicated by the incidence of carpal tunnel syndrome after ulnar neuropathy diagnosis [8].
• Use of a collagen matrix wrap in recurrent compression neuropathies of the upper extremity has shown good success [9].
• Surgical decompression for carpal tunnel syndrome is associated with a greater decrease in median nerve cross-sectional area than nonsurgical treatment [10].
• Anterior interosseous nerve transfer combined with cubital and ulnar tunnel release results in sustained clinical and electrophysiological improvements in severe chronic ulnar nerve compression [14].
• Anterior interosseous nerve transfer combined with cubital and ulnar tunnel release is encouraged as a standard treatment for severe chronic ulnar nerve compression [14].
• Endoscopic decompression for anterior interosseous nerve syndrome can achieve the same proximal and distal extents of the nerve as open techniques [15].
• Endoscopic decompression for anterior interosseous nerve syndrome uses an incision nearly one fourth the size of open techniques, minimizing morbidity, blood loss, and recovery time [15].
• Extensive decompression of the ulnar nerve beyond the cubital tunnel is not routinely needed, supported by satisfactory outcomes with endoscopic detection of compressing fascial bands within the FCU [17].

Anatomy & Pathophysiology

• Compression neuropathies of the upper extremity involve a double-crush mechanism [1].
• Systemic factors play a role in the pathophysiology of compression neuropathies of the upper extremity [1].
• Intracarpal tunnel pressures during active hand use are substantially greater than previously reported in patients with carpal tunnel syndrome [21].
• Perineural lipoma of the ulnar nerve can occur within the cubital tunnel [25].
• Sensorimotor control impairment can occur after wrist trauma [27].
• Distal radius fracture management requires evaluation of all potential causes for early carpal tunnel syndrome findings, including prominent volar cortical fragments causing direct pressure or prominently placed hardware [34].
• Ulnar nerve entrapment neuropathy at the elbow is associated with non-task-specific focal hand dystonia [41].

Classification

• Compression neuropathies of the upper extremity involve a double-crush mechanism [1].
• Systemic factors contribute to the pathophysiology of compression neuropathies of the upper extremity [1].
• Compressive neuropathy management complications include iatrogenic injury, treatment failure, and pathologic pain syndromes [2].
• Prevention of compressive neuropathy complications relies on understanding normal anatomy and anatomic variations [2].
• Diagnosis and treatment of compressive neuropathies are shifting towards preoperative imaging with ultrasound and MRN [3].
• Management of failed decompressions for compressive neuropathies remains challenging [3].
• Most publications on uncommon upper extremity compression syndromes (radial, ulnar, median nerves) are small retrospective series or case reports [4].
• Treatment decisions for uncommon upper extremity compression syndromes are not typically based on high levels of evidence [4].
• Debulking of a tumor along with median nerve decompression relieved neurological symptoms in a child with tuberous sclerosis complex causing carpal tunnel syndrome and thumb overgrowth [5].
• Minimally invasive in situ decompression is technically simple, safe, and provides good results for severe ulnar nerve entrapment at the elbow [6].
• Pseudogout is a rare cause of acute carpal tunnel syndrome and acute Guyon canal syndrome [7].
• Ulnar nerve pathology may precede and increase susceptibility to median nerve compression [8].
• Surgical decompression for carpal tunnel syndrome is associated with a greater decrease in median nerve cross-sectional area than nonsurgical treatment [10].
• Concurrent carpal tunnel syndrome and pronator syndrome are rarely considered, and proximal compression sites are easily overlooked [11].
• Ganglia are the most common cause of ulnar tunnel syndrome [12].
• Symptoms of ulnar tunnel syndrome vary based on the anatomic location of the compression within Guyon's canal [12].
• The term double crush syndrome is proposed to be expanded to multifocal neuropathy to describe the complex interplay of mechanical, systemic, pharmacological, and environmental factors contributing to nerve dysfunction [13].
• Unusual compression neuropathies of the forearm include posterior interosseous nerve syndrome, radial tunnel syndrome, and superficial radial nerve compression (Wartenberg's syndrome) [16].
• In-situ release is an alternative for managing McGowen grade 3 ulnar nerve compression neuropathy at the elbow, with a similar success rate to submuscular and intramuscular transpositions but a lower complication rate [23].

Clinical Presentation

• Compression neuropathies of the upper extremity involve a double-crush mechanism [1].
• Systemic factors contribute to the pathophysiology of compression neuropathies of the upper extremity [1].
• Ulnar nerve pathology may precede and increase susceptibility to median nerve compression [8].
• Concurrent carpal tunnel syndrome and pronator syndrome are rarely considered, and proximal compression sites are easily overlooked [11].
• Intracarpal tunnel pressures during active hand use in patients with carpal tunnel syndrome are substantially greater than previously reported [21].
• Ganglia are the most common cause of ulnar tunnel syndrome [12].
• Symptoms of ulnar tunnel syndrome vary based on the anatomic location of the compression within Guyon's canal [12].
• Pseudogout is a rare cause of acute neuropathic compression of the hand, including acute carpal tunnel syndrome and acute Guyon canal syndrome [7].
• Collagenoma in a child with tuberous sclerosis complex can cause carpal tunnel syndrome and thumb overgrowth [5].
• Uncommon compression syndromes of the radial, ulnar, and median nerves exist, with most publications being small retrospective series or case reports [4].
• Unusual compression neuropathies of the forearm include posterior interosseous nerve syndrome, radial tunnel syndrome, and superficial radial nerve compression (Wartenberg's syndrome) [16].
• A punched nerve syndrome of the deep motor branch of the ulnar nerve is a rare presentation [18].
• Multifocal neuropathy describes the complex interplay of mechanical, systemic, pharmacological, and environmental factors contributing to nerve dysfunction [13].

Investigations

• Diagnosis and treatment of compressive neuropathies are shifting towards preoperative imaging with ultrasound and MRN [3].
• Most publications on uncommon upper extremity compression syndromes are small retrospective series or case reports, and treatment decisions are not typically based on high levels of evidence [4].
• Debulking of a tumor along with median nerve decompression relieved neurological symptoms in a child with tuberous sclerosis complex causing carpal tunnel syndrome [5].
• Pseudogout is a rare cause of acute neuropathic compression of the hand, including acute carpal tunnel syndrome and acute Guyon canal syndrome [7].
• Ulnar nerve pathology may precede and increase susceptibility to median nerve compression [8].
• Concurrent carpal tunnel syndrome and pronator syndrome are rarely considered, and proximal compression sites are easily overlooked [11].
• Ganglia are the most common cause of ulnar tunnel syndrome, and symptoms vary based on the anatomic location of the compression within Guyon's canal [12].
• Endoscopic decompression for anterior interosseous nerve syndrome can be achieved over the same proximal and distal extents of the nerve as open techniques but with an incision nearly one fourth the size, minimizing morbidity, blood loss, and recovery time [15].
• Unusual compression neuropathies of the forearm specifically include posterior interosseous nerve syndrome, radial tunnel syndrome, and superficial radial nerve compression (Wartenberg's syndrome) [16].
• High-resolution ultrasound (HRUS) is a viable method to demonstrate a punched nerve syndrome of the deep motor branch of the ulnar nerve [18].
• Ultrasound measurements have limited value in predicting clinical results of patients treated for entrapment neuropathy of the ulnar nerve [19].
• After surgery for perineural lipoma of the ulnar nerve within the cubital tunnel, shooting pain resolved, sensation normalized in digits four and five, and hand strength gradually improved [25].
• The diagnostic accuracy of nerve conduction studies for ulnar neuropathy at the elbow may be lower than 80%–90% and depends on the severity of the neuropathy [33].
• Short segment testing is suggested to improve the diagnostic accuracy of nerve conduction studies for ulnar neuropathy at the elbow [33].

Treatment

• Conservative treatment benefits the majority of patients with cubital tunnel syndrome who present with mild or moderate symptoms [22].
• Surgical decompression is associated with a greater decrease in median nerve cross-sectional area compared to nonsurgical treatment [10].
• Debulking of a tumor along with median nerve decompression provides relief of neurological symptoms in cases such as collagenoma causing carpal tunnel syndrome [5].
• Minimally invasive in situ decompression is technically simple, safe, and yields good results for severe ulnar nerve entrapment at the elbow [6].
• In-situ release is an alternative for managing McGowen grade 3 ulnar nerve compression neuropathy at the elbow, offering a similar success rate to submuscular and intramuscular transpositions with a lower complication rate [23].
• Anterior interosseous nerve transfer combined with cubital and ulnar tunnel release results in sustained clinical and electrophysiological improvements in patients with severe chronic ulnar nerve compression [14].
• Minimally invasive endoscopic decompression for anterior interosseous nerve syndrome achieves the same proximal and distal extents of the nerve as open techniques but with an incision nearly one-fourth the size, minimizing morbidity, blood loss, and recovery time [15].
• Extensive decompression of the ulnar nerve beyond the cubital tunnel is not routinely needed, as satisfactory outcomes are supported by endoscopic detection of compressing fascial bands within the flexor carpi ulnaris [17].
• A novel technique using a collagen matrix wrap in recurrent compression neuropathies has shown good success [9].
• Pseudogout should be considered a rare cause of acute neuropathic compression of the hand, including acute carpal tunnel syndrome and acute Guyon canal syndrome [7].
• Complications of compressive neuropathy management include iatrogenic injury, treatment failure, and pathologic pain syndromes, with prevention relying on a solid understanding of normal anatomy and anatomic variations [2].
• The management of failed decompressions remains challenging as diagnosis and treatment evolve with technology, shifting towards preoperative imaging with ultrasound and MRN [3].

Complications

• Complications of compressive neuropathy management include iatrogenic injury [2].
• Complications of compressive neuropathy management include treatment failure [2].
• Complications of compressive neuropathy management include pathologic pain syndromes [2].
• Prevention of complications relies on a solid understanding of normal anatomy and anatomic variations [2].
• Management of failed decompressions remains challenging [3].
• Nerve injuries following elbow arthroscopy are likely under-reported in the literature [29].
• The number of severe nerve injuries following elbow arthroscopy may be much higher than previously thought [29].

Recovery

• Minimally invasive in situ decompression for severe ulnar nerve entrapment at the elbow is technically simple, safe, and provides good functional outcomes [6].
• Endoscopic decompression of the anterior interosseous nerve achieves the same proximal and distal extents as open techniques but with an incision nearly one-fourth the size, minimizing morbidity, blood loss, and recovery time [15].
• Extensive decompression of the ulnar nerve beyond the cubital tunnel is not routinely needed, as satisfactory outcomes are supported by endoscopic detection of compressing fascial bands within the flexor carpi ulnaris [17].
• Revision decompression combined with a collagen nerve wrap demonstrates good success in managing recurrent and persistent compression neuropathies of the upper extremity [9].
• Anterior interosseous nerve transfer combined with cubital and ulnar tunnel release results in sustained clinical and electrophysiological improvements in patients with severe chronic ulnar nerve compression [14].
• Early diagnosis and careful excision of epineural ganglia causing ulnar nerve compression in the cubital tunnel are associated with satisfactory outcomes, although complete electrophysiological recovery may not occur if symptoms have been present for a prolonged period [20].
• Debulking of a tumor along with median nerve decompression provides relief of neurological symptoms in cases such as collagenoma-induced carpal tunnel syndrome [5].
• Long-term improvement following carpal tunnel release in patients with diabetes is maintained to the same extent as in patients without diabetes [24].
• Treatment decisions for uncommon upper extremity compression syndromes are not typically based on high levels of evidence, as most publications are small retrospective series or case reports [4].
• Management of failed decompressions remains challenging despite evolving diagnostic and treatment technologies such as preoperative ultrasound and MRN [3].

Key Evidence

• [L5] Complications of compressive neuropathy management include iatrogenic injury, treatment failure, and pathologic pain syndromes, with prevention relying on a solid understanding of normal anatomy and anatomic variations. (10.1016/j.hcl.2015.01.012)
• [L5] The diagnosis and treatment of compressive neuropathies continue to evolve with technology, shifting towards preoperative imaging with ultrasound and MRN, while the management of failed decompressions remains challenging. (10.1016/j.jhsg.2022.10.009)
• [L4] This article reviews uncommon compression syndromes of the radial, ulnar, and median nerves, noting that most publications are small retrospective series or case reports and treatment decisions are not typically based on high levels of evidence. (10.1016/j.hcl.2013.04.014)
• [Case_report] Debulking of the tumor along with median nerve decompression was performed with relief of neurological symptoms. (10.1016/j.jhsa.2013.07.004)
• [L3] Minimally invasive in situ decompression is technically simple, safe and gives good results in patients with severe nerve compression. (10.1177/1753193411416426)
• [L4] Pseudogout should be considered a rare cause of acute neuropathic compression of the hand. (10.1016/j.jhsg.2022.07.010)
• [L2] This supports the hypothesis that ulnar nerve pathology may precede and increase susceptibility to median nerve compression. (10.1016/j.jhsg.2026.100970)
• [L4] The authors report on the novel technique of using a collagen matrix wrap in recurrent compression neuropathies with good success. (10.1097/sap.0b013e3182956475)
• [L3] Surgical decompression was associated with a greater decrease in median nerve cross-sectional area than nonsurgical treatment. (10.1016/j.jhsa.2010.06.010)
• [L4] Concurrent carpal tunnel syndrome and pronator syndrome are rarely considered and proximal compression sites are easily overlooked. (10.1016/j.otsr.2016.10.009)
• [L5] The article provides a comprehensive review of the anatomy, pathophysiology, and causes of ulnar tunnel syndrome, noting that ganglia are the most common cause and that symptoms vary based on the anatomic location of the compression within Guyon's canal. (10.1016/j.hcl.2007.06.006)
• [L5] The authors propose expanding the term from double crush syndrome to multifocal neuropathy to better describe the complex interplay of mechanical, systemic, pharmacological, and environmental factors contributing to nerve dysfunction. (10.1016/j.jhsa.2016.09.009)
• [L4] Anterior interosseous nerve transfer, along with cubital and ulnar tunnel release, results in sustained clinical and electrophysiological improvements in patients with severe chronic ulnar nerve compression, which encourages its adoption as a standard treatment for severe chronic ulnar nerve compression. (10.1177/17531934251381023)
• [L4] Endoscopic decompression can be achieved over the same proximal and distal extents of the nerve as open techniques but with an incision nearly one fourth the size, minimizing morbidity, blood loss, and recovery time. (10.1016/j.jhsa.2013.07.026)
• [L5] This article is a review examining unusual compression neuropathies of the forearm, specifically focusing on the radial nerve, including posterior interosseous nerve syndrome, radial tunnel syndrome, and superficial radial nerve compression (Wartenberg's syndrome). (10.1016/j.jhsa.2009.10.016)
• [L4] The satisfactory outcomes support the perception that extensive decompression of the ulnar nerve beyond the cubital tunnel is not routinely needed. (10.1007/s11552-011-9377-x)
• [L4] HRUS is a viable method to demonstrate a punched nerve syndrome. (10.1007/s00402-015-2216-8)
• [L3] Ultrasound (US) measurements seem to have a limited value in clinical results of patients treated for entrapment neuropathy of the ulnar nerve. (10.1177/1558944719857816)
• [Case_report] Early diagnosis and careful excision of epineural ganglia are associated with satisfactory outcomes, although complete electrophysiological recovery may not occur if symptoms have been present for a prolonged period. (10.1007/s11552-006-9013-3)
• [L4] In patients with carpal tunnel syndrome, intracarpal tunnel pressures during active hand use are substantially greater than previously reported. (10.1016/j.jhsa.2009.09.019)
• [L2] The majority of patients suffering from cubital tunnel syndrome with mild or moderate symptoms benefit from conservative treatment. (10.1177/1753193408098480)
• [L4] Thus, in-situ release could be an alternative in management of patients with McGowen grade 3 ulnar nerve compression neuropathy at the elbow with a similar success rate as the submuscular and intramuscular transpositions with a lower complication rate. (10.1016/j.jhsa.2015.06.068)
• [L2] Long-term improvement in patients with diabetes remained after carpal tunnel release to the same extent as for patients without diabetes. (10.1016/j.jhsa.2014.01.012)
• [L4] After surgery, shooting pain resolved, sensation normalized in digits four and five, and hand strength gradually improved. (10.1016/j.jhsg.2025.100889)
• [L5] This clinical review discusses the organization, neuroanatomy, assessment, clinical relevance, and rehabilitation of sensorimotor control impairment after wrist trauma, proposing promising rehabilitation strategies that require more rigorous evaluation in clinical trials. (10.1016/j.jht.2015.12.003)
• [L4] Nerve injuries are likely under-reported in the literature, and this study indicates that the number of severe nerve injuries may be much higher than previously thought. (10.1016/j.jhsa.2013.08.025)
• [L5] The diagnostic accuracy of nerve conduction studies for ulnar neuropathy at the elbow may be lower than 80%–90% and depends on the severity of the neuropathy; short segment testing is suggested to improve accuracy. (10.1177/17531934241288802)
• [Paper] If early carpal tunnel syndrome findings are noted during distal radius fracture management, all potential causes should be evaluated, including prominent volar cortical fragments causing direct prominently placed hardware. (10.1016/j.ocl.2012.07.021)
• [L4] This case establishes a clear-cut relationship between ulnar nerve entrapment neuropathy at the elbow and non-task-specific focal hand dystonia, demonstrated by the dramatic recovery of clinical and electrophysiological parameters after surgical decompression. (10.1007/s11552-010-9280-x)

References

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