Background. Eight patients with 11 instances of wrist-level ulnar nerv
e entrapment, a fairly uncommon compression syndrome, were identified
in a hand surgery practice from 1992 through 1996. Methods. Presentati
ons, causes, and surgical outcomes were examined, and the pertinent li
terature was reviewed. Results. All eight patients had extrinsic, noni
diopathic compression of the ulnar nerve caused by tumor, vascular dis
ease, anomalous muscle development, or a tight fibrous arch at the ori
gin of the flexor digiti minimi. In all cases, sensory symptoms resolv
ed with removal of the cause of ulnar nerve compression. Conclusions.
These cases serve to remind physicians that not every instance of numb
ness and tingling in the hand represents carpal tunnel syndrome. Caref
ul clinical examination may not only localize compression of the ulnar
nerve at wrist level but also may reveal its etiology. Some causes of
ulnar compressive neuropathy, however, are apparent only with surgica
l exploration.