Ulnar Nerve Injury at the Elbow after Steroid Injection for Medial Epicondylitis

Abstract

We describe an accidental injury to the ulnar nerve at the elbow following steroid injection for medial epicondylitis in a patient with undetected recurrent dislocation of the nerve. The chalky substance found on exploration to intermingle with the nerve fascicles was removed and the nerve was placed under the flexor-pronator mass. After surgery, complete resolution of the epicondylar pain was noted, along with significant improvement in two-point discrimination of the ulnar digits. We recommend clinical assessment of the ulnar nerve location prior to injection to avoid injury. Should recurrent dislocation of the nerve be diagnosed, injection should be given cautiously, preferably with the elbow in an extended or semiflexed position.