Natural history of ulnar entrapment at elbow

Objective: No clinical–neurophysiological data on natural history of ulnar neuropathy at elbow (UNE) are reported. The aim of the current study is to assess the course of untreated UNE. Methods: We performed a follow-up at 1 year of 30 neurophysiologically positive UNE, 24 were untreated and 6 were operated on. The evaluation was based on a phone interview and sometimes on neurophysiological investigation. With regard to management of UNE, at initial evaluation we explained to the patients what UNE is and how to avoid posture that can worsen nerve compression. Results: Around half of the untreated patients reported improvement of symptoms at follow-up. Comparison between baseline and follow-up neurophysiological measurements showed a significant spontaneous improvement. Most patients reported changing of arm posture after UNE diagnosis. Conclusions: Some UNE cases improve spontaneously without surgical treatment. A part of the improvements could be due to the changing of arm postures. We hypothesize that a good diagnosis that includes an explanation of the anatomical condition of the nerve during postures and movements represents the first therapy for the entrapments.