Investigations in Ulnar Nerve Palsy: Ultrasound, MRI and Nerve Conduction Studies - Simplified

[@kevinlapu2758]

Great, clear and detailed explanation .

[@hakimorthopaedics]

Dear Dr. Gomathinayagam, I've watched your teaching videos .. these are amazing.. If possible, could you give us lectures on free flaps principles, like principles of recipient site dissection and preparation

[@GKHandSurgery]

Definitely, Abdelhakim Marei! Thank you for the suggestions.

[@mkmohan699]

Please make vedio on ulnar nerve injury management

[@GKHandSurgery]

Yes, will be coming soon!

[@mkmohan699]

@@GKHandSurgery Thank you sir

[@fobin1985]

Nicely explained sir.thanks.

[@GKHandSurgery]

Thanks for liking

[@praweshsinghbhandari6462]

X-ray of elbow shows non union of lateral condyle Best explanation for us students

[@GKHandSurgery]

Thanks for the clarification

[@wasimz3431]

Thank you Dr. I do have one question, after cupital tunnel surgery. When do you expect to get the strength of Grip and nerve healing. And if there is muscles atrophy can be reversible

[@GKHandSurgery]

It depends on the damage that has already occurred to the nerve before the release. EMG done before the surgery will show the degree of damage to the muscles. If there has been no irreversible damage to the muscles, recovery can be expected in 3 months.

[@wasimz3431]

@@GKHandSurgery thank you dr. This is my EMG below MEDICAL REPORT CLINICAL NEUROPHYSIOLOGY SERVICE ELECTROMYOGRAM REPORT EMG of the anterior ulnar muscles, abductor digiti minimi and first dorsal interosseous of the MSD: -Active denervation (positive waves and fibrillations) in abductor digiti minimi. -interferential-intermediate recruitment in the first dorsal and intermediate interosseous in the anterior ulnar and abductor digiti minimi. -PUM of increased duration, with an increase in polyphasia greater than 10% in the explored muscles. ENG: Sensory conduction of the median and ulnar nerve of the MSD: - Conduction speed at the limit of normality in the median nerve. -no potential evoked in ulnar. Motor conduction of the median and ulnar nerve of the MSD: -Slightly prolonged distal latency in the median nerve. - Decreased amplitudes of ulnar nerve CMAPs, with slowed conduction velocity in the axonal range in the segments explored (wrist / under-elbow and under-elbow / supra-elbow). CONCLUSION: - Axonal neuropathy (not localizable) of the right ulnar, of moderate-severe degree, of chronic evolution with signs of partial reinnervation present, and active denervation in the hypothenar distal motor branch (finger abductor muscle). - Mild distal motor involvement of the right median nerve at the level of the carpal tunnel,

[@GKHandSurgery]

@@wasimz3431 The NCS and EMG definitely shows the involvement of the ulnar nerve, but we need to correlate clinically to come to a correct diagnosis and conclusion.

[@wasimz3431]

@@GKHandSurgery you are right Dr. I already did the operation 30 days ago. That's why I'm asking about the muscles and if the weakness and wasting in some parts will be recovered. Do I need physiotherapy. Thank you so much dr

[@GKHandSurgery]

@@wasimz3431 That is very definite, the need for physiotherapy. Please consult your surgeon, who will guide you. Wish you a good recovery!

[@biplabdas1103]

Can I take vaccine after surgery

[@GKHandSurgery]

Yes, a minimum of 3 weeks after surgery

[@gamaltaher9714]

Thanks

[@GKHandSurgery]

Welcome