Patient Education for the Treatment of Ulnar Neuropathy at the Elbow

Handout for patient education. (A) Page 1 provides advice in writing. (B) Page 2 depicts activities and postures to avoid: (1) crossing arms over the body or reaching the neck or chin, especially while attending a meeting; (2) use of a phone (using the opposite hand, a headset, or shoulder cradle recommended) or carrying a box or bag with its straps on the shoulder; (3) lying with the elbows flexed or leaning upon them; and (4) push-ups, sit-ups, weightlifting, or other elbow exercises. (C) Page 3 shows examples (sitting and computer keyboard use) to maintain the elbow in 45° of flexion. A goniometer set at this angle (*) was used for the education.

Grading of degenerative change of the elbow (upper panel, anteroposterior view; lower panel, cubital tunnel projection profiling the ulnar nerve groove [*]). (A) Normal. (B) Mild; osteophytes present only on the medial olecranon (arrow), not deforming the nerve groove. (C) Moderate; osteophytes present also on the medial humeral trochlea (arrow), deforming the groove. (D) Severe; in addition to a deformed groove, valgus deformity present (increase in carrying angle, 20° or greater in comparison with the angle of the contralateral elbow) due to a fracture of the lateral humeral condyle in childhood.