Subluxating ulnar nerve

Subluxation of the ulnar nerve at the elbow can be seen in 12-15% of the normal population and can be asymptomatic. The nerve usually subluxes in flexion as seen in this video. If the patient has no symptoms and no neurologic findings then surgery is not indicated. It may be associated with snapping of the medial triceps.

The clinical importance of this condition is the following:

1. In case elbow arthroscopy is planned the proximal medial portal can result in ulnar nerve damage which may lead to permanent dysfunction of the hand/arm

2. If symptomatic and presentation mimics cubital tunnel syndrome findings then it is important to evaluate intra-operatively what makes the ulnar nerve sublux. This is performed by exposing the ulnar nerve proximal to the medial epicondyle and flexing the elbow while inspecting the wound. Sometimes snapping over the medial triceps or intermuscular septum may be seen.

It is commonly seen in throwers and bodybuilders and surgery is necessary if symptomatic.