Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive paresthesia and numbness involving the left small finger and ulnar aspect of the ring finger. Symptoms are exacerbated by prolonged elbow flexion. Reports associated weakness in grip strength and occasional clumsiness with fine motor tasks. Denies trauma, neck pain, or radiation of symptoms proximal to the elbow.
Clinical Examination Findings
Left upper extremity examination reveals positive Tinelβs sign at the cubital tunnel and positive elbow flexion test. Sensory testing demonstrates diminished light touch and pinprick sensation in the ulnar nerve distribution. Motor testing shows 4+/5 strength in the first dorsal interosseous and abductor digiti minimi. No visible atrophy of the hypothenar eminence or interossei noted.
Treatment Protocol
Conservative management initiated including activity modification, avoidance of prolonged elbow flexion, and use of a nocturnal extension splint. NSAIDs prescribed for symptomatic relief. Physical therapy referral for nerve gliding exercises and ergonomic assessment. Follow-up in 6 weeks to assess for clinical improvement or need for electrodiagnostic studies.