Sulcus ulnaris Syndrom

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Der N. ulnaris (deutsch Ellennerv) läuft auf der Innenseite des Ellenbogens im sog. Sulcus ulnaris. An dieser Stelle verläuft der Nerv sehr oberflächlich, weshalb er für mechanische Irritationen anfällig ist. Während der „Musikantenknochen“ nur eine kurze Irritation des N. ulnaris darstellt, kann der Nerv durch Verwachsungen/ Vernarbungen oder nach Unfällen eingeengt werden und so zu einer dauerhaften Irritation an Ring- und Kleinfinger der Hand führen. Dies kann durch eine neurologische Untersuchung mit Messung der Nervenleitgeschwindigkeit verifiziert werden.
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Die betroffenen Patienten leiden unter Irritation von Klein- und Ringfinger- das Ausmaß ist dabei sehr variabel und kann von nur gelegentlichem „Einschlafen“ bis hin zu dauerhaftem Taubheitsgefühl reichen. Als Diagnostik wird in der Regel neben der neurologischen Untersuchung auch eine MRT-Diagnostik durchgeführt, um anatomische Besonderheiten, die den Nerv beispielsweise einengen können, darzustellen.
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Bei einem „leichten“ Sulcus ulnaris Syndrom kann es schon ausreichend sein, wenn die auslösenden Tätigkeiten konsequent vermieden werden. Als Therapieoption kann darüber hinaus auch eine Nachtlagerungsschiene eingesetzt werden, die verhindern soll, dass der Arm in einer starken Beugestellung gehalten wird.
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Im Rahmen des operativen Eingriffes wird der Nerv vorsichtig von Verwachsungen gelöst und dargestellt. Sollten ausgeprägte Veränderungen vorliegen, so ist ggfs. die Verlagerung des Nerven indiziert, um ein entsprechendes Rezidivrisiko zu vermeiden. Bei bereits neurologisch nachgewiesenen Schädigungen ist auch nach einem Release eine Rehabilitation von einigen Monaten zu erwarten.
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