The ulnar nerve passes behind the medial epicondyle of the distal humerus at the elbow.
It is often referred to as “the funny bone” because when provoked it causes a funny sensation in the little and ring fingers.
In reality, it is a mechanical irritation of a nerve which causes a sensory disturbance in the hand.
In very late cases there may also be motor signs or weakness. This manifest as wasting of the small muscles in the and. Most of these small muscles are supplied by the ulnar nerve.
The first dorsal interosseous muscle is the “last lightbulb on the end of the wire” so that if it is intact then you can conclude that so is everything above (proximal) to it. Dr Kirkham will examine you for Froment’s sign, as well as weakness of the hand intrinsic muscles.
Nerve conduction studies are often normal (unlike in carpal tunnel syndrome) because this ulnar nerve compression (or friction or traction) is intermittent rather than static. EMG in late cases can be used but typically isn’t needed before a first consultation.
Ulnar nerve surgery takes several forms these day. An ulnar nerve transposition is a common procedure. It is highly recommended that any Nerve surgery is performed by a clinician , preferably a fully trained hand surgeon, who is highly experienced in that procedure – such as Dr Kirkham.