Clinical History
19-year-old male collegiate baseball pitcher with ulnar nerve deficit after flexor tendon repair.
Diagnosis: Unintended Suturing of the Ulnar Nerve During Flexor Tendon Repair at the Elbow
This is a case of the ulnar nerve having inadvertently been sutured during intended flexor tendon repair.
The initial surgery had been performed at an outside institution. The orthopedic surgeon presumably thought the ulnar nerve was the abnormal flexor tendon, and it was sutured onto the medial epicondyle of the distal humerus.
Ultrasound is a great modality for assessing soft tissues including nerves. The outstanding spatial resolution of ultrasound allows direct visualization of foreign bodies such as suture, and size and morphology of the ulnar nerve that may be signs of nerve irritation can be assessed.
In this case, the diagnosis of inadvertent suturing of the ulnar nerve was confirmed by subsequent surgery at our institution.