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.
Authors
- Manuela Gaviria (ORCID: https://orcid.org/0000-0002-6966-5591)
- James A. Albright (ORCID: https://orcid.org/0000-0001-9579-9924)
- Casey M. Sabbag (ORCID: https://orcid.org/0000-0001-8739-8899)
- Natalia Pluta (ORCID: https://orcid.org/0000-0003-3718-570X)
- David J. Wilson (ORCID: https://orcid.org/0009-0005-8898-5653)
- Josiah Snowden
- Mariah Arave (ORCID: https://orcid.org/0000-0002-8142-6622)
- Braden N. Miller (ORCID: https://orcid.org/0009-0009-6181-401X)
Institutions
- Brooke Army Medical Center (US)
- The University of Texas at San Antonio Health Science Center (US)
- Joint Base San Antonio (US)
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
- Field-Weighted Citation Impact
- 0.00