Double Crush Ulnar Nerve Palsy with Vascular Compression Causing First Dorsal Interosseous and Adductor Deficit

CASE: We present a case of a 30-year-old man with severe ulnar nerve neuropraxia and first dorsal interosseous muscle wasting. Intraoperatively, a large venous plexus compressing the terminal division of the deep motor branch of the ulnar nerve was identified as a contributing factor. CONCLUSION: This is the first documented instance of compression of the terminal branch of the ulnar nerve caused by a venous plexus, resulting in neurapraxia. This rare anatomical variant caused progressive functional impairment and was successfully treated with ligation of vessels distally along with proximal and distal nerve decompression.

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Publication Details

Journal
JBJS Case Connector
Published
2026-04-01
DOI
https://doi.org/10.2106/jbjs.cc.25.00543
Primary Topic
Peripheral Nerve Disorders
Type
article
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article

Double Crush Ulnar Nerve Palsy with Vascular Compression Causing First Dorsal Interosseous and Adductor Deficit

Manuela Gaviria, James A. Albright, Casey M. Sabbag, Natalia Pluta et al.
JBJS Case Connector
Peripheral Nerve Disorders
article

Double Crush Ulnar Nerve Palsy with Vascular Compression Causing First Dorsal Interosseous and Adductor Deficit

Manuela Gaviria, James A. Albright, Casey M. Sabbag, Natalia Pluta, David J. Wilson, Josiah Snowden, Mariah Arave, Braden N. Miller
article en

Abstract

CASE: We present a case of a 30-year-old man with severe ulnar nerve neuropraxia and first dorsal interosseous muscle wasting. Intraoperatively, a large venous plexus compressing the terminal division of the deep motor branch of the ulnar nerve was identified as a contributing factor. CONCLUSION: This is the first documented instance of compression of the terminal branch of the ulnar nerve caused by a venous plexus, resulting in neurapraxia. This rare anatomical variant caused progressive functional impairment and was successfully treated with ligation of vessels distally along with proximal and distal nerve decompression.

JBJS Case ConnectorVol. 16(2)
Brooke Army Medical Center (US), The University of Texas at San Antonio Health Science Center (US), Joint Base San Antonio (US)
Openalex Percentile: Top 18%
Peripheral Nerve Disorders
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Double Crush Ulnar Nerve Palsy with Vascular Compression Causing First Dorsal Interosseous and Adductor Deficit — Manuela Gaviria, James A. Albright, et al. · JBJS Case Connector (2026) | TGRS Research Map | TGRS