Case Report: Ulnar Tunnel Syndrome in a Bicyclist
In this case report, surgeons from the Naval Medical Center in San Diego, California present the result of surgical treatment for ulnar tunnel syndrome (UTS).

A 29-year old woman presented with UTS after an 80-mile bike ride. UTS is the compression of the ulnar nerve in the wrist and hand at the base of the little finger side of the hand. Prolonged pressure on the hand at that site can put enough pressure on the nerve to cause UTS.

Symptoms range from pain and numbness to tingling, weakness, and muscle atrophy. This woman had all of these symptoms along with decreased sensation int he ring and little fingers. Conservative care did not help. She had surgery to release the pressure on the nerve.

The surgeons reported that the ulnar nerve was flattened and narrowed. There was no other damage to the ulnar nerve tunnel. There were no other tumors, hematomas, or lesions in the area.

Her symptoms gradually went away. Strength and motion improved. By the end of 10 weeks post-operatively, she was back to normal. Even the tenderness around her incision was gone.

Most cases of UTS resolve with conservative care using splinting, rest, and avoiding activities that caused the problem in the first place. But surgeons should be aware that in some cases, ulnar tunnel release might be needed.

With more people involved in long-distance biking events, UTS may be something surgeons see more often in the near future. They should know that surgery is an acceptable treatment if conservative care fails. Results can be 100 per cent successful.
References
LT Stacey Black, MD, MC, USN, et al. A Unique Case of Ulnar Tunnel Syndrome in a Bicyclist Requiring Operative Release. In The American Journal of Orthopedics. July 2007. Vol. 36. No. 7. Pp. 377-379.