Where in the elbow region is the ulnar nerve most likely to be compressed?

Updated: Jun 08, 2018
  • Author: Charles F Guardia, III, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

Although the current state of knowledge is still incomplete, it is possible to identify approximately five sites in the elbow region at which the ulnar nerve is most likely to be compressed. (Five is not a firm figure; some of the sites are so close together that certain authorities categorize them differently to get a different number.) This article principally follows Posner’s classification, [28] which lists the following sites (see the image below):

  • Above the elbow in the region of the intermuscular septum

  • The medial epicondylar region

  • The epicondylar (ie, ulnar) groove

  • The region of the cubital tunnel

  • The region where the ulnar nerve exits from the flexor carpi ulnaris, at which the usual cause of compression is the deep flexor-pronator aponeurosis

    Schematic diagram of elbow region, with 5 main sit Schematic diagram of elbow region, with 5 main sites (as given by Posner) labeled 1-5; other sites and structures are also named. Main regions of interest are circled with pastel-colored arrows. Sites 2 and 3 are close together and cannot be distinguished by means of electromyography and nerve conduction studies. This location is referred to as ulnar (or epicondylar) groove.

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